Healthcare Provider Details

I. General information

NPI: 1376405100
Provider Name (Legal Business Name): REBEKAH SPRINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4790 SW WATSON AVE
BEAVERTON OR
97005-0511
US

IV. Provider business mailing address

4790 SW WATSON AVE
BEAVERTON OR
97005-0511
US

V. Phone/Fax

Practice location:
  • Phone: 503-905-9735
  • Fax: 503-386-7898
Mailing address:
  • Phone: 503-905-9735
  • Fax: 503-386-7898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: REBEKAH SPRINGS
Title or Position: OWNER
Credential: LMFT
Phone: 916-436-6992