Provider Demographics
NPI:1265788145
Name:MORGAN, REBECCA JEAN (PT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:JEAN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17650 140TH AVE SE
Mailing Address - Street 2:SUITE B-07
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-6814
Mailing Address - Country:US
Mailing Address - Phone:425-430-0070
Mailing Address - Fax:425-430-0710
Practice Address - Street 1:2904 4TH AVE NE
Practice Address - Street 2:SUITE 300
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-7053
Practice Address - Country:US
Practice Address - Phone:253-840-2313
Practice Address - Fax:253-840-6340
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60280846225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist