Provider Demographics
NPI:1619326873
Name:DRON, REBEKAH ANNE (LMT)
Entity Type:Individual
Prefix:MISS
First Name:REBEKAH
Middle Name:ANNE
Last Name:DRON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10868 MAIN ST NE
Mailing Address - Street 2:
Mailing Address - City:DONALD
Mailing Address - State:OR
Mailing Address - Zip Code:97020-7000
Mailing Address - Country:US
Mailing Address - Phone:503-430-4664
Mailing Address - Fax:
Practice Address - Street 1:8695 SW JACK BURNS BLVD
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-5797
Practice Address - Country:US
Practice Address - Phone:503-427-2698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR21667225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist