Healthcare Provider Details

I. General information

NPI: 1154959260
Provider Name (Legal Business Name): REBECCA CATHRYNE HULSTEIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 04/01/2020
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SE WASHINGTON AVE
CHEHALIS WA
98532-3058
US

IV. Provider business mailing address

12715 E MISSION AVE
SPOKANE VALLEY WA
99216-1027
US

V. Phone/Fax

Practice location:
  • Phone: 509-232-5766
  • Fax:
Mailing address:
  • Phone: 360-507-8032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN60282697
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: