Individual
REBECCA WAXMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17 S WESTERN AVE, TONASKET, WA 98855-9270
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60447299
WA
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285056606
—
WA
01
—
P01544679
RR PTAN WVH
WA
Enumeration date
01/21/2014
Last updated
12/14/2015
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