1730246216 NPI number — MS. REBECCA ELIN GEIS MS,OTR/L

Table of content: MS. REBECCA ELIN GEIS MS,OTR/L (NPI 1730246216)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730246216 NPI number — MS. REBECCA ELIN GEIS MS,OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEIS
Provider First Name:
REBECCA
Provider Middle Name:
ELIN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS,OTR/L
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TYLER
Provider Other First Name:
REBECCA
Provider Other Middle Name:
ELIN- GEIS
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS,OTRL
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730246216
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1111 CORNWALL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLINGHAM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98225-5039
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-734-8396
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1111 CORNWALL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98225-5039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-734-5121
Provider Business Practice Location Address Fax Number:
855-224-7921
Provider Enumeration Date:
01/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225XH1300X , with the licence number:  1009417 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , with the licence number: 61223113 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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