Individual
REBECCA LYNN THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
16202 SE 19TH STREET, VANCOUVER, WA 98683
(360) 885-2125
Mailing address
13501 NE 28TH STREET, EVERGREEN PUBLIC SCHOOLS, VANCOUVER, WA 98683
(360) 604-6700
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/22/2013
Last updated
01/22/2013
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