Provider Demographics
NPI:1255454724
Name:MACMULLAN, REBECCA KEMNITZ (EAMP)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:KEMNITZ
Last Name:MACMULLAN
Suffix:
Gender:F
Credentials:EAMP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:KEMNITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:2020 E 29TH AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-3950
Mailing Address - Country:US
Mailing Address - Phone:509-270-5088
Mailing Address - Fax:509-443-5417
Practice Address - Street 1:2020 E 29TH AVE STE 210
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-3950
Practice Address - Country:US
Practice Address - Phone:509-270-5088
Practice Address - Fax:509-443-5417
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002338171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist