Provider Demographics
NPI:1619474160
Name:CARSTENS, REBECCA DWAN
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:DWAN
Last Name:CARSTENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6209 N COULEE HITE RD
Mailing Address - Street 2:
Mailing Address - City:REARDAN
Mailing Address - State:WA
Mailing Address - Zip Code:99029-9621
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6209 N COULEE HITE RD
Practice Address - Street 2:
Practice Address - City:REARDAN
Practice Address - State:WA
Practice Address - Zip Code:99029-9621
Practice Address - Country:US
Practice Address - Phone:509-979-9474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer