MEDICARE: MRS. REBECCA LOUISE LANCASTER DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT60757017	WA

General Provider Information

NPI Number	:	1003331992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA LOUISE LANCASTER DPT

Provider Business Mailing Address
First Line	:	1027 REGENTS BLVD
Second Line	:
City	:	FIRCREST
State	:	WA
Zip	:	98466-6030
Country	:	US
Telephone Number	:	253-301-3783
Fax Number	:	253-301-3254

Provider Business Practice Location Address
First Line	:	1027 REGENTS BLVD
Second Line	:
City	:	FIRCREST
State	:	WA
Zip	:	98466-6030
Country	:	US
Telephone Number	:	253-301-3783
Fax Number	:	253-301-3254

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2017
Last Update Date	:	07/21/2022

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