Provider Demographics
NPI:1225367881
Name:REHN, ELISABETH ANN (LICSW)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:ANN
Last Name:REHN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 108TH AVE NE
Mailing Address - Street 2:UNIT 2815
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-5580
Mailing Address - Country:US
Mailing Address - Phone:425-454-1199
Mailing Address - Fax:425-454-8779
Practice Address - Street 1:400 108TH AVE NE
Practice Address - Street 2:#402
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5562
Practice Address - Country:US
Practice Address - Phone:425-454-1199
Practice Address - Fax:425-454-8779
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-10
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC 602726871041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker