Provider Demographics
NPI:1265300602
Name:KALAKEWICH, REBECCA ROSE (ARNP)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ROSE
Last Name:KALAKEWICH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2679 S YOUNG CT
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-1540
Mailing Address - Country:US
Mailing Address - Phone:772-233-6513
Mailing Address - Fax:
Practice Address - Street 1:2679 S YOUNG CT
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-1540
Practice Address - Country:US
Practice Address - Phone:772-233-6513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61005362163W00000X
WAAP70052042363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse