MEDICARE: MS. REBECCA JANE SCHILTZ LMFT

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
1	106H00000X	Marriage & Family Therapist	LF60102426	WA

General Provider Information

NPI Number	:	1871745216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBECCA JANE SCHILTZ LMFT

Provider Business Mailing Address
First Line	:	1812 SUMNER AVE
Second Line	:	SUITE I
City	:	ABERDEEN
State	:	WA
Zip	:	98520-4602
Country	:	US
Telephone Number	:	360-532-0060
Fax Number	:	360-532-0061

Provider Business Practice Location Address
First Line	:	4007 BRIDGEPORT WAY W
Second Line	:	SUITE F-2
City	:	UNIVERSITY PLACE
State	:	WA
Zip	:	98466-4330
Country	:	US
Telephone Number	:	253-565-2208
Fax Number	:	360-532-0061

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2008
Last Update Date	:	03/18/2010

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