Provider Demographics
NPI:1083857478
Name:VON DUERING, REBECCA KARIN (MS, CCC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:KARIN
Last Name:VON DUERING
Suffix:
Gender:
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 257 PMB 11208
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98507-0257
Mailing Address - Country:US
Mailing Address - Phone:206-372-6152
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 257 PMB 11208
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98507-0257
Practice Address - Country:US
Practice Address - Phone:206-372-6152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP15085235Z00000X
OR18088235Z00000X
WASI60042650235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist