Basic Information
| Provider Information | |||||||||
| NPI: | 1255319117 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REHDER | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | T. | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5252 116TH PL SE. | ||||||||
| Address2: | |||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4257362758 | ||||||||
| FaxNumber: | 2534463239 | ||||||||
| Practice Location | |||||||||
| Address1: | 5252 116TH PL SE. | ||||||||
| Address2: | |||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4257362758 | ||||||||
| FaxNumber: | 2534463239 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2006 | ||||||||
| LastUpdateDate: | 09/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LW0005396 | WA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.