Provider Demographics
NPI:1184286049
Name:DOW, REBECCA (LMT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:DOW
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 1:22790 BUCHANAN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-8023
Mailing Address - Country:US
Mailing Address - Phone:360-856-5562
Mailing Address - Fax:360-856-4923
Practice Address - Street 1:22790 BUCHANAN ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-8023
Practice Address - Country:US
Practice Address - Phone:360-856-5562
Practice Address - Fax:360-856-4923
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60902271225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist