Provider Demographics
NPI:1548493257
Name:BECKWITH, DAVID WAYNE (RC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:WAYNE
Last Name:BECKWITH
Suffix:
Gender:M
Credentials:RC
Other - Prefix:
Other - First Name:DAVE
Other - Middle Name:WAYNE
Other - Last Name:BECKWITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:SOUND MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:4028 S 146TH ST
Practice Address - Street 2:PACIFIC COURT APARTMENTS, SMH
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-4374
Practice Address - Country:US
Practice Address - Phone:206-719-8517
Practice Address - Fax:206-302-2210
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC60101056101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional