Provider Demographics
NPI:1821540519
Name:HARBURG, REBECCA (DIPL OM, LAC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:HARBURG
Suffix:
Gender:F
Credentials:DIPL OM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 NE FRANKLIN AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4960
Mailing Address - Country:US
Mailing Address - Phone:541-678-0986
Mailing Address - Fax:
Practice Address - Street 1:244 NE FRANKLIN AVE STE 1
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4960
Practice Address - Country:US
Practice Address - Phone:541-350-5633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-27
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC179638171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist