Jacqueline Beckwith, FNP
Individual provider Active NPI Family Nurse Practitioner · Sandy, OR
NPI 1366420739 · NPPES record last updated Oct 18, 2016
Key facts
- NPI
- 1366420739
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 200650004NP (OR)
- Practice address
- 37400 Bell St
Sandy, OR 97055-7868 - Phone
- (503) 668-3483
- Fax
- (503) 668-1892
- NPI assigned
- Jan 5, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200650004NP | OR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canby Healthcare Clinic LLC | Past | Accepting new patients | |
| Joseph P Stapleton MD, PC | Past | Accepting new patients | |
| Canby Healthcare Clinic LLC | Past |
Accepting new patients | |
| Division Street Family Practice Clinic PC | Past | Accepting new patients | |
| Clackamas County | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 200650004NP | OR | Yes |
Addresses
Primary practice location
37400 Bell St
Sandy, OR 97055-7868
Mailing address
2051 Kaen Rd
Ste 367
Oregon City, OR 97045-4035
Phone (503) 742-5300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 240448 | Medicaid | OR |
Other providers in Sandy, OR
- Kaley Brianne Archibald Goers
- Nancy Ashley
- Avamere Sandy Operations, LLC
- Jonessa Felices Barrios
- Lisa Bayer
- Emily C Bennett
- Melanie Bertenelli
- Bruce Alan Biermann
- Beth Ann Biggs
- Chelsea Boppre
All providers in Sandy, OR · Family Nurse Practitioner in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.