Provider Demographics
NPI:1407144280
Name:STEEL, REBECCA (LMP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:STEEL
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10109 21ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-4226
Mailing Address - Country:US
Mailing Address - Phone:425-773-0491
Mailing Address - Fax:425-290-8051
Practice Address - Street 1:1920 100TH ST SE
Practice Address - Street 2:SUITE A3
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3832
Practice Address - Country:US
Practice Address - Phone:425-381-3866
Practice Address - Fax:425-316-3839
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60109891225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist