| Doctor Name: | TABITHA BECKER |
| NPI Number: | 1023411485 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 2484 |
| Business Practice Address: | 201 B Ave Suite 285 Lake Oswego, OR - 970343159 |
| Business Phone Number: | 5036360508 |
| Business Fax Number: | 5036360387 |
| Mailing Address: | 201 B Ave, Suite 285 LAKE OSWEGO |
| State: | OR |
| Postal Code: | 970343159 |
| Phone Number: | 5036360508 |
| Fax Number: | 5036360387 |
| NPI Enumeration Date: | 09/30/2014 |
| NPI Last Update Date: | 09/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103G00000X |
| License Number: | 2484 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Clinical Neuropsychologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |