Provider Demographics
NPI:1447907381
Name:MCMARTIN, REBECCA (MDIV)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MCMARTIN
Suffix:
Gender:F
Credentials:MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 NE CHURCH ST APT 301
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-3284
Mailing Address - Country:US
Mailing Address - Phone:503-505-8934
Mailing Address - Fax:
Practice Address - Street 1:2924 FALK RD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-5604
Practice Address - Country:US
Practice Address - Phone:360-690-3069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral