Provider Demographics
NPI:1477882348
Name:SKRIFVARS, REBECCA ANN (MA, LMFT, CEDS)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:SKRIFVARS
Suffix:
Gender:F
Credentials:MA, LMFT, CEDS
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ANN
Other - Last Name:GROVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:16300 MILL CREEK BLVD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1737
Mailing Address - Country:US
Mailing Address - Phone:425-686-9221
Mailing Address - Fax:425-984-0335
Practice Address - Street 1:1200 5TH AVE STE 800
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-3136
Practice Address - Country:US
Practice Address - Phone:206-374-0109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-23
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61909106H00000X
WALF60297280106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist