Provider Demographics
NPI:1336771872
Name:AUGSBURGER, REBECCA ROSE (PT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ROSE
Last Name:AUGSBURGER
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 1:1811 52ND WAY SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-8000
Mailing Address - Country:US
Mailing Address - Phone:360-888-2344
Mailing Address - Fax:
Practice Address - Street 1:710 FIELDSTONE DR SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5500
Practice Address - Country:US
Practice Address - Phone:360-888-2344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA10474225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist