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Individual

KRISTA DANIELLE BECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
9155 SW BARNES RD STE 440, PORTLAND, OR 97225-6631
(503) 935-8500
(503) 935-8505
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA197167
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500776774
OR
Enumeration date
02/20/2020
Last updated
11/22/2023
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