Provider Demographics
NPI:1780100826
Name:KLINGMAN, REBECCA A (MS)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:KLINGMAN
Suffix:
Gender:
Credentials:MS
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:A
Other - Last Name:SERRANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:203 4TH AVE E STE 222
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1187
Mailing Address - Country:US
Mailing Address - Phone:360-890-7444
Mailing Address - Fax:
Practice Address - Street 1:203 4TH AVE E STE 222
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1187
Practice Address - Country:US
Practice Address - Phone:360-890-7444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
WALH61049684101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH61049684OtherDOH