Provider Demographics
NPI:1669781183
Name:BECKER, NATALIA (LMT)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:BECKER
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 1:165 E 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:ESTACADA
Mailing Address - State:OR
Mailing Address - Zip Code:97023-8580
Mailing Address - Country:US
Mailing Address - Phone:503-630-6555
Mailing Address - Fax:503-630-2838
Practice Address - Street 1:165 E 1ST AVE
Practice Address - Street 2:
Practice Address - City:ESTACADA
Practice Address - State:OR
Practice Address - Zip Code:97023-8580
Practice Address - Country:US
Practice Address - Phone:503-630-6555
Practice Address - Fax:503-630-2838
Is Sole Proprietor?:No
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12024172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist