Provider Demographics
NPI:1851874127
Name:SWEET, REBEKAH ANN (LMT)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:ANN
Last Name:SWEET
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 1:3443 SE COMPASS LN APT 101
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-6338
Mailing Address - Country:US
Mailing Address - Phone:757-849-8110
Mailing Address - Fax:
Practice Address - Street 1:7700 PIONEER WAY STE 101
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1164
Practice Address - Country:US
Practice Address - Phone:253-509-0258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60844153225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist