Provider Demographics
NPI:1487856274
Name:STRUNK, REBECCA AHMANN (BA)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:AHMANN
Last Name:STRUNK
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:MARGARET
Other - Last Name:AHMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:883 COTTAGE ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-2427
Mailing Address - Country:US
Mailing Address - Phone:503-999-4507
Mailing Address - Fax:
Practice Address - Street 1:883 COTTAGE ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2427
Practice Address - Country:US
Practice Address - Phone:503-999-4507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator