Provider Demographics
NPI:1770734931
Name:LOMNICKY, REBECCA DORIS (AUD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:DORIS
Last Name:LOMNICKY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 S UNION AVE
Mailing Address - Street 2:B-2010
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1702
Mailing Address - Country:US
Mailing Address - Phone:253-627-4502
Mailing Address - Fax:253-627-4465
Practice Address - Street 1:1901 S UNION AVE
Practice Address - Street 2:B-2010
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1702
Practice Address - Country:US
Practice Address - Phone:253-627-4502
Practice Address - Fax:253-627-4465
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD60046883231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist