Provider Demographics
NPI:1639149974
Name:SAUNDERS, REBECCA R (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:R
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 SW 43RD
Mailing Address - Street 2:#200
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-4801
Mailing Address - Country:US
Mailing Address - Phone:425-271-4910
Mailing Address - Fax:425-264-1041
Practice Address - Street 1:1412 SW 43RD ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-4801
Practice Address - Country:US
Practice Address - Phone:425-271-4910
Practice Address - Fax:425-264-1041
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00033822174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8199051Medicaid
WAG34402Medicare UPIN
WA8199051Medicaid