Healthcare Provider Details
I. General information
NPI: 1992272439
Provider Name (Legal Business Name): REBEKAH POWERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/01/2018
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9720 S TACOMA WAY
LAKEWOOD WA
98499-4456
US
IV. Provider business mailing address
9720 S TACOMA WAY
LAKEWOOD WA
98499-4456
US
V. Phone/Fax
- Phone: 253-503-3666
- Fax:
- Phone: 253-304-7753
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: