Provider Demographics
NPI:1548573579
Name:RAWSON, REBECCA BARRETT (FNP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:BARRETT
Last Name:RAWSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 12TH ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1538
Mailing Address - Country:US
Mailing Address - Phone:541-386-1818
Mailing Address - Fax:541-386-3225
Practice Address - Street 1:902 12TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1538
Practice Address - Country:US
Practice Address - Phone:541-386-1818
Practice Address - Fax:541-386-3225
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201050025NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500640721Medicaid
ORR164261Medicare PIN