Provider Demographics
NPI:1447311352
Name:BROWN, REBECCA LYNN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:LYNN
Last Name:BROWN
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Gender:F
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:11481 SW HALL BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8403
Mailing Address - Country:US
Mailing Address - Phone:800-219-8835
Mailing Address - Fax:503-443-1402
Practice Address - Street 1:58147 COLUMBIA RIVER HWY
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051-6226
Practice Address - Country:US
Practice Address - Phone:503-397-1914
Practice Address - Fax:503-366-0422
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-11-06
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Provider Licenses
StateLicense IDTaxonomies
OR5316225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR136444Medicare PIN