Individual
EDMUND C BECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9290 SE SUNNYBROOK BLVD, SUITE 120, CLACKAMAS, OR 97015-6802
(503) 215-2110
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD22686
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288095
—
OR
01
—
P00765699
RR MEDICARE - PROVIDENCE
OR
Enumeration date
06/28/2006
Last updated
02/05/2021
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