Provider Demographics
NPI:1013319391
Name:FILIPOWICZ, REBECCA (PA-C, MS)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:FILIPOWICZ
Suffix:
Gender:F
Credentials:PA-C, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 262
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-0262
Mailing Address - Country:US
Mailing Address - Phone:866-676-5690
Mailing Address - Fax:
Practice Address - Street 1:63351 US HIGHWAY 93
Practice Address - Street 2:
Practice Address - City:RONAN
Practice Address - State:MT
Practice Address - Zip Code:59864-2702
Practice Address - Country:US
Practice Address - Phone:406-676-5680
Practice Address - Fax:406-676-5690
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT42564363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant