Provider Demographics
NPI:1811600752
Name:RAYMOND, REBECCA ANN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11104 E 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-8633
Mailing Address - Country:US
Mailing Address - Phone:509-481-1510
Mailing Address - Fax:
Practice Address - Street 1:10623 E SPRAGUE AVE STE B
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-3699
Practice Address - Country:US
Practice Address - Phone:509-859-8020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61382084363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health