Provider Demographics
NPI:1932447562
Name:BECK, JULIE ANNE (LMT)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANNE
Last Name:BECK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9765 SW SATTLER ST
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-5720
Mailing Address - Country:US
Mailing Address - Phone:503-746-4765
Mailing Address - Fax:
Practice Address - Street 1:9765 SW SATTLER ST
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-5720
Practice Address - Country:US
Practice Address - Phone:503-746-4765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13241225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist