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General NPI Number Information
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NPI Number | 1174144711
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Entity Type | Individual
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Provider Name | REBECCA C EMIREN PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/06/2020
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Last Update Date | 08/23/2023
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Provider Practice Location Address
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Address Line | 11102 SUNRISE BLVD E STE 104
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City | PUYALLUP
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State | WA
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Zip | 98374-8846
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Country | US
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Telephone | 253-848-8797
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Fax | 253-845-1114
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Provider Business Mailing Address
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Address Line | PO BOX 5299 MS: 820-5-PCO
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City | TACOMA
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State | WA
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Zip | 98415-0299
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.00666RX
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA61354505
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License Number State | WA
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