Individual
BLAKE J. BECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
510 8TH AVE NE STE 310, ISSAQUAH, WA 98029-5436
(425) 462-5006
(425) 462-5019
Mailing address
510 8TH AVE NE STE 310, ISSAQUAH, WA 98029-5436
(425) 462-5006
(425) 462-5019
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA56794
CA
363A00000X
Physician Assistant
PA61261831
WA
363AS0400X
Surgical Physician Assistant
Primary
PA61261831
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2212954
—
WA
Enumeration date
05/20/2019
Last updated
03/21/2024
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