Provider Demographics
NPI:1053704932
Name:GALLAGHER, REBECCA (LMHCA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20010 RIDGE RD SW
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-6266
Mailing Address - Country:US
Mailing Address - Phone:425-256-0981
Mailing Address - Fax:
Practice Address - Street 1:2702 N PROCTOR ST
Practice Address - Street 2:SUITE C
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-5228
Practice Address - Country:US
Practice Address - Phone:425-256-0981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC 60537115101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health