Provider Demographics
NPI:1285447003
Name:BECKHAM, JESSICA L (ARNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:BECKHAM
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 164TH ST SW APT 2337
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-3112
Mailing Address - Country:US
Mailing Address - Phone:425-750-8107
Mailing Address - Fax:
Practice Address - Street 1:3333 164TH ST SW APT 2337
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-3112
Practice Address - Country:US
Practice Address - Phone:425-750-8107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61649775363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily