Provider Demographics
NPI:1417148941
Name:KNOX, REBEKAH L (LMP)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:L
Last Name:KNOX
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 1:11701 MERIDIAN PL NE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-8680
Mailing Address - Country:US
Mailing Address - Phone:425-308-5963
Mailing Address - Fax:
Practice Address - Street 1:3116A 188TH ST NE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-9812
Practice Address - Country:US
Practice Address - Phone:360-653-8307
Practice Address - Fax:360-653-7813
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019981225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist