Organization
EAR NOSE THROAT FACIAL PLASTIC SURGERY AND ALLERGY OF WESTERN WA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANCY A BECKER DO (PRESIDENT)
(360) 825-4466
Entity
Organization
Contact information
Practice address
1427 JEFFERSON AVE, ENUMCLAW, WA 98022-3613
(360) 825-4466
(360) 825-2064
Mailing address
1427 JEFFERSON AVE STE 101, ENUMCLAW, WA 98022-3649
(360) 825-4466
(360) 825-2064
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
—
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
OP00001317
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7144611
—
WA
Enumeration date
10/28/2008
Last updated
01/08/2019
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