Provider Demographics
NPI:1871913491
Name:PERKINS, REBECCA K (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:K
Last Name:PERKINS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1671 OLSON RD
Mailing Address - Street 2:
Mailing Address - City:PALOUSE
Mailing Address - State:WA
Mailing Address - Zip Code:99161-9774
Mailing Address - Country:US
Mailing Address - Phone:509-878-1547
Mailing Address - Fax:
Practice Address - Street 1:1671 OLSON RD
Practice Address - Street 2:
Practice Address - City:PALOUSE
Practice Address - State:WA
Practice Address - Zip Code:99161-9774
Practice Address - Country:US
Practice Address - Phone:509-878-1547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-2542235Z00000X
WA60336343235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist