Healthcare Provider Details

I. General information

NPI: 1740197433
Provider Name (Legal Business Name): REBEKAH ANNE FANKHAUSER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1824 FRONT ST STE A
LYNDEN WA
98264-1729
US

IV. Provider business mailing address

1824 FRONT ST STE A
LYNDEN WA
98264-1729
US

V. Phone/Fax

Practice location:
  • Phone: 360-354-0585
  • Fax:
Mailing address:
  • Phone: 360-354-0585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.PT.70142678
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: