Healthcare Provider Details

I. General information

NPI: 1518876614
Provider Name (Legal Business Name): REBECCA AUSTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6625 WAGNER WAY STE 203
GIG HARBOR WA
98335-8392
US

IV. Provider business mailing address

6625 WAGNER WAY STE 203
GIG HARBOR WA
98335-8392
US

V. Phone/Fax

Practice location:
  • Phone: 253-256-1532
  • Fax: 312-500-4317
Mailing address:
  • Phone: 253-256-1532
  • Fax: 312-500-4317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number0158292
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: