Provider Demographics
NPI:1811539182
Name:BYERS, REBECCA L (LMT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:BYERS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2477 ADMIRAL RD NE
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-9713
Mailing Address - Country:US
Mailing Address - Phone:509-431-8718
Mailing Address - Fax:
Practice Address - Street 1:2477 ADMIRAL RD NE
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-9713
Practice Address - Country:US
Practice Address - Phone:509-431-8718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60982643225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty