Provider Demographics
NPI:1740618321
Name:OLDENKAMP, REBEKAH JOANNE (ND)
Entity Type:Individual
Prefix:MS
First Name:REBEKAH
Middle Name:JOANNE
Last Name:OLDENKAMP
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 CEDAR AVENUE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290
Mailing Address - Country:US
Mailing Address - Phone:425-778-5673
Mailing Address - Fax:425-774-2421
Practice Address - Street 1:110 CEDAR AVENUE
Practice Address - Street 2:SUITE 101
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290
Practice Address - Country:US
Practice Address - Phone:425-778-5673
Practice Address - Fax:425-774-2421
Is Sole Proprietor?:No
Enumeration Date:2013-10-17
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT604143663175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath