Provider Demographics
NPI:1932188851
Name:REHMANN, GREGORY JUDE (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JUDE
Last Name:REHMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 E ROWAN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207
Mailing Address - Country:US
Mailing Address - Phone:509-483-3155
Mailing Address - Fax:509-487-1636
Practice Address - Street 1:42 E ROWAN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207
Practice Address - Country:US
Practice Address - Phone:509-483-3155
Practice Address - Fax:509-487-1636
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00037397207Q00000X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA080143897OtherRAILROAD MEDICARE
WA1108281Medicaid
134530OtherL & I
134530OtherL & I
WA1108281Medicaid