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General NPI Number Information
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NPI Number | 1265062970
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Entity Type | Individual
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Provider Name | REBECCA EWER
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Gender | Female
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Dates
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Enumeration Date | 01/22/2020
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Last Update Date | 01/22/2020
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Provider Practice Location Address
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Address Line | 415 N MORAIN ST
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City | KENNEWICK
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State | WA
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Zip | 99336-2667
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Country | US
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Telephone | 509-735-6900
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Fax | 509-735-6914
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Provider Business Mailing Address
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Address Line | 6102 WESTMORLAND LN
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City | PASCO
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State | WA
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Zip | 99301-8691
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Country | US
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Telephone | 509-947-5202
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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