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Individual
REBECCA S SOUZA
Active
Individual
REBECCA S SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004607
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0181108
LABOR AND INDUSTRY
WA
05
—
8394785
—
WA
01
—
P00162972
RAILROAD MEDICARE
WA
01
—
PA10004607
STATE LICENSE NUMBER
WA
Enumeration date
05/28/2006
Last updated
01/13/2008
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