Beck, Blake J.

Beck, Blake J. is an individual health care provider with primary practice located at 510 8Th Ave Ne Ste 310 , Issaquah WA 98029-5436. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Beck, Blake J. can be contacted via phone (425) 462-5006.

Contact Information

Primary practice address
510 8Th Ave Ne Ste 310 Issaquah WA 98029-5436
Phone: (425) 462-5006
Fax: (425) 462-5019
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA56794 California
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA61261831 Washington
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA61261831 Washington

Profile Details

NPI number 1104483783
LBN Legal business name Beck, Blake J.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2019
Last updated Mar 21st, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104483783 NPPES
Washington MEDICAID 2212954

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