Individual
REBECCA SUZANNE FOREMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1615 DELAWARE ST, SUITE 200, LONGVIEW, WA 98632-2367
(360) 501-3547
Mailing address
1115 SE 164TH AVE, DEPT. 358, VANCOUVER, WA 98683-9324
(360) 729-1462
(360) 729-3104
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2010014001
MO
207N00000X
Dermatology Physician
Primary
MD60356693
WA
207R00000X
Internal Medicine Physician
125.056329
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2029200
—
WA
05
—
500656692
—
OR
Enumeration date
06/17/2009
Last updated
04/12/2016
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