Provider Demographics
NPI:1821417247
Name:STELTZER, REBEKAH (LMP)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:STELTZER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 NW TOWLE AVE
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-5330
Mailing Address - Country:US
Mailing Address - Phone:503-208-0072
Mailing Address - Fax:
Practice Address - Street 1:1050 NW TOWLE AVE
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-5330
Practice Address - Country:US
Practice Address - Phone:503-208-0072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00010664225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist