Individual
DR. BECK ORMAN LONGSTREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1415 E KINCAID ST, MOUNT VERNON, WA 98274-4126
(360) 428-2166
Mailing address
5000 HOPYARD RD, SUITE 100, PLEASANTON, CA 94588-3348
(925) 924-1600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD169039
OR
207P00000X
Emergency Medicine Physician
Primary
MD60591922
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD60591922
LICENSE
WA
Enumeration date
04/01/2013
Last updated
04/10/2017
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