Provider Demographics
NPI:1255674917
Name:REHBERGER, LISA (MSN, ARNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:REHBERGER
Suffix:
Gender:F
Credentials:MSN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 POINT FOSDICK DR NW STE 219
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1706
Mailing Address - Country:US
Mailing Address - Phone:253-851-7733
Mailing Address - Fax:253-851-8060
Practice Address - Street 1:4707 S 19TH ST STE 130
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1151
Practice Address - Country:US
Practice Address - Phone:253-522-2737
Practice Address - Fax:253-759-0914
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006555363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner