Nicole Kristine Beck, MA CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Tualatin, OR

NPI 1346576162 · NPPES record last updated Oct 29, 2009

Key facts

NPI
1346576162
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
12276 (OR)
Practice address
19250 SW 65TH Ave
Medical Plaza 1, Suite 125
Tualatin, OR 97062-7452
Phone
(503) 692-1783
NPI assigned
Oct 29, 2009
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
12276ORMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Meridian Park Hospital Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 12276 OR Yes

Addresses

Primary practice location

19250 SW 65TH Ave
Medical Plaza 1, Suite 125
Tualatin, OR 97062-7452

Mailing address

19250 SW 65TH Ave
Medical Plaza 1, Suite 125
Tualatin, OR 97062-7452
Phone (503) 692-1783

Other providers in Tualatin, OR

All providers in Tualatin, OR · Speech-Language Pathologist in Oregon

Sources for this page

Verify at the official NPI Registry.