Provider Demographics
NPI:1518574011
Name:NORRIS, REBECCA LEE-WON (SUDP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LEE-WON
Last Name:NORRIS
Suffix:
Gender:F
Credentials:SUDP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:KRAUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REBECCA ROTH
Mailing Address - Street 1:1229 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98337-1250
Mailing Address - Country:US
Mailing Address - Phone:715-529-1250
Mailing Address - Fax:
Practice Address - Street 1:2903 PERRY AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310
Practice Address - Country:US
Practice Address - Phone:360-663-5683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP61612069101YA0400X
171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)