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NPI Code Detail

MEDICARE: REBECCA GARETZ

MEDICARE: REBECCA GARETZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1790132546
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA GARETZ
Provider Business Mailing Address
First Line : 71 MANZANA CT NW APT 2D
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49534-5789
Country : US
Telephone Number : 925-640-8479
Fax Number :
Provider Business Practice Location Address
First Line : 3407 S CORBETT AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97239-4621
Country : US
Telephone Number : 360-830-6632
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2016
Last Update Date : 09/18/2025

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Directions to “ REBECCA GARETZ ” Practice Location

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