Provider Demographics
NPI:1942709142
Name:LEE, REBEKAH NICOLE (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:NICOLE
Last Name:LEE
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:NICOLE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9133 126TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-3450
Mailing Address - Country:US
Mailing Address - Phone:918-453-3597
Mailing Address - Fax:
Practice Address - Street 1:2929 5TH AVE NE STE A
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-6782
Practice Address - Country:US
Practice Address - Phone:253-447-8216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-03
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-03321225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist