Provider Demographics
NPI:1699894881
Name:RUDD, REBECCA ANNE (PHD, LMFT, LMHC, RPT)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ANNE
Last Name:RUDD
Suffix:
Gender:F
Credentials:PHD, LMFT, LMHC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 W RIVERSIDE AVE
Mailing Address - Street 2:SUITE 670
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0405
Mailing Address - Country:US
Mailing Address - Phone:509-879-4860
Mailing Address - Fax:509-202-4322
Practice Address - Street 1:407 E 2ND AVE STE 250
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1439
Practice Address - Country:US
Practice Address - Phone:509-315-9776
Practice Address - Fax:509-202-4322
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TF0000X
WALH60063971101YM0800X
WALF60074423106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1699894881Medicaid