Provider Demographics
NPI:1467892174
Name:LOUIE, REBEKAH W (OD)
Entity Type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:W
Last Name:LOUIE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17314 18TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6482
Mailing Address - Country:US
Mailing Address - Phone:206-356-7678
Mailing Address - Fax:
Practice Address - Street 1:10990 HARBOR HILL DR
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8945
Practice Address - Country:US
Practice Address - Phone:425-217-9858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14651152W00000X
WA60459336152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist