Individual
DANIEL R BECKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10709 S WALTON RD, ISLAND CITY, OR 97850-8490
(541) 962-7753
(541) 963-0750
Mailing address
10709 S WALTON RD, ISLAND CITY, OR 97850-8490
(541) 962-7753
(541) 963-0750
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3035AT
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122908
—
OR
01
—
4821750001
CIGNA GOV. SERVICES
OR
Enumeration date
03/08/2006
Last updated
09/13/2012
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