Provider Demographics
NPI:1700288677
Name:LANG, REBECCA ANNE (ND)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANNE
Last Name:LANG
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8423 MUKILTEO SPEEDWAY STE 101
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-3237
Mailing Address - Country:US
Mailing Address - Phone:425-423-0878
Mailing Address - Fax:
Practice Address - Street 1:8423 MUKILTEO SPEEDWAY STE 101
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-3237
Practice Address - Country:US
Practice Address - Phone:425-423-0878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60497520175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath