Provider Demographics
NPI:1356017149
Name:HANDY, REBEKKA MAYE
Entity Type:Individual
Prefix:
First Name:REBEKKA
Middle Name:MAYE
Last Name:HANDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REBEKKA
Other - Middle Name:
Other - Last Name:MAYE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:13900 SE HIGHWAY 212 UNIT 170
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-8417
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13900 SE HIGHWAY 212 UNIT 170
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-8417
Practice Address - Country:US
Practice Address - Phone:503-703-8760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty