Provider Demographics
NPI:1427500016
Name:COBB, REBECCA
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:COBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 W DRAVUS ST
Mailing Address - Street 2:1
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98199-2445
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2110 W DRAVUS ST
Practice Address - Street 2:1
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98199-2445
Practice Address - Country:US
Practice Address - Phone:818-424-5528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-29
Last Update Date:2016-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60471759106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist