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General NPI Number Information
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NPI Number | 1295881126
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Entity Type | Organization
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Legal Business Name | REBECCA PERBIX MALLOS MSW INC
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8011 118TH AVE NE
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City | KIRKLAND
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State | WA
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Zip | 98033
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Country | US
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Telephone | 425-889-8524
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Fax | 425-576-8274
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Provider Business Mailing Address
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Address Line | 8011 118TH AVE NE
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City | KIRKLAND
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State | WA
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Zip | 98033
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Country | US
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Telephone | 425-889-8524
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Fax | 425-576-8274
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. REBECCA PERBIX MALLOS
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Credential | MSW
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Telephone | 425-889-8524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW 00004346
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License Number State | WA
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