MEDICARE: RHONDA LEEANN BRECKENRIDGE LICSW

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	1041C0700X	Clinical Social Worker	LW60243517	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609153592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA LEEANN BRECKENRIDGE LICSW

Provider Business Mailing Address
First Line	:	600 ORONDO AVE
Second Line	:
City	:	WENATCHEE
State	:	WA
Zip	:	98801-2800
Country	:	US
Telephone Number	:	509-662-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	980 EASTMONT AVE
Second Line	:
City	:	EAST WENATCHEE
State	:	WA
Zip	:	98802-6602
Country	:	US
Telephone Number	:	509-662-6000
Fax Number	:

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

Provider Enumeration Date	:	11/07/2011
Last Update Date	:	02/21/2025

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