Provider Demographics
NPI:1831380344
Name:BECK, FORREST (ND)
Entity type:Individual
Prefix:DR
First Name:FORREST
Middle Name:
Last Name:BECK
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3370 N HAYDEN RD STE 123
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6632
Mailing Address - Country:US
Mailing Address - Phone:480-702-1782
Mailing Address - Fax:833-336-2983
Practice Address - Street 1:4020 E. INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018
Practice Address - Country:US
Practice Address - Phone:480-702-1782
Practice Address - Fax:833-336-2983
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ03-708175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA86-1063869OtherFEDERAL TAX ID
AZ03-708OtherMEDICAL LICENSE