Provider Demographics
NPI:1073832622
Name:PARKER, REBECCA E (SLP)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:E
Last Name:PARKER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:E
Other - Last Name:FALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4046 49TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-3609
Mailing Address - Country:US
Mailing Address - Phone:206-618-5210
Mailing Address - Fax:
Practice Address - Street 1:4046 49TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-3609
Practice Address - Country:US
Practice Address - Phone:206-618-5210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60062979235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist