Provider Demographics
NPI:1629313598
Name:SEVERINGHAUS, REBECCA KATHERINE
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:KATHERINE
Last Name:SEVERINGHAUS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:KATHERINE
Other - Last Name:RUHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8818 E GRACE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2165
Mailing Address - Country:US
Mailing Address - Phone:509-922-5478
Mailing Address - Fax:509-921-5259
Practice Address - Street 1:8818 E GRACE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99212-2165
Practice Address - Country:US
Practice Address - Phone:509-922-5478
Practice Address - Fax:509-921-5259
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 00001361235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist