Provider Demographics
NPI:1366809907
Name:KALISH, REBECCA M (RN)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:M
Last Name:KALISH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:M
Other - Last Name:BETTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9040 REID STREET
Mailing Address - Street 2:ATTN: MCHJ-CLQ-C MADIGAN ARMY MEDICAL CENTER
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-1000
Mailing Address - Country:US
Mailing Address - Phone:253-968-1110
Mailing Address - Fax:877-874-1031
Practice Address - Street 1:9040 REID STREET
Practice Address - Street 2:ATTN: MCHJ-CLQ-C MADIGAN ARMY MEDICAL CENTER
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1000
Practice Address - Country:US
Practice Address - Phone:253-968-1110
Practice Address - Fax:877-874-1031
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60065670163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse