Provider Demographics
NPI:1548382609
Name:BECKEL, REBECCA S (LMP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:S
Last Name:BECKEL
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:S
Other - Last Name:BECKEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMP
Mailing Address - Street 1:PO BOX 301
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-0301
Mailing Address - Country:US
Mailing Address - Phone:206-419-9024
Mailing Address - Fax:360-794-7236
Practice Address - Street 1:26311 NE VALLEY STREET
Practice Address - Street 2:
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019
Practice Address - Country:US
Practice Address - Phone:206-419-9024
Practice Address - Fax:360-794-7236
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013895225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist