Provider Demographics
NPI:1063717346
Name:BECK, BROOKE NICOLE-DOROTHY (ND)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:NICOLE-DOROTHY
Last Name:BECK
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-1556
Mailing Address - Country:US
Mailing Address - Phone:715-494-0548
Mailing Address - Fax:
Practice Address - Street 1:415 NE BIRCH ST
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-2139
Practice Address - Country:US
Practice Address - Phone:360-834-2732
Practice Address - Fax:360-834-3063
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1730R175F00000X
WANT 60551540175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath