Provider Demographics
NPI:1063661858
Name:TAMAKI, REBECCA ROSE (DPT)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:ROSE
Last Name:TAMAKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ROSE
Other - Last Name:REDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5039 CHESS DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5632
Mailing Address - Country:US
Mailing Address - Phone:907-563-4115
Mailing Address - Fax:907-563-4116
Practice Address - Street 1:3801 UNIVERSITY LAKE DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-561-8681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1971225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist