Provider Demographics
NPI:1255319117
Name:REHDER, PAMELA T (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:T
Last Name:REHDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5252 116TH PL SE.
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006
Mailing Address - Country:US
Mailing Address - Phone:425-736-2758
Mailing Address - Fax:253-446-3239
Practice Address - Street 1:5252 116TH PL SE.
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006
Practice Address - Country:US
Practice Address - Phone:425-736-2758
Practice Address - Fax:253-446-3239
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-02
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00053961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical