Provider Demographics
NPI:1649418773
Name:NERISON, REBECCA MAE (PHD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MAE
Last Name:NERISON
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:9040A FITZSIMMONS DR
Mailing Address - Street 2:INTERNAL MEDICINE CLINIC - MAMC
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-1100
Mailing Address - Country:US
Mailing Address - Phone:253-968-5154
Mailing Address - Fax:253-968-5154
Practice Address - Street 1:9040A FITZSIMMONS DR
Practice Address - Street 2:INTERNAL MEDICINE CLINIC - MAMC
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1100
Practice Address - Country:US
Practice Address - Phone:253-968-5154
Practice Address - Fax:253-968-5154
Is Sole Proprietor?:No
Enumeration Date:2009-01-28
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA2213103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling