Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 00037397 | WA |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 00037397 | WA |
NPI | 1932188851 |
---|---|
Provider Name | Dr. Gregory Jude Rehmann |
First Address | Spokane, WA 99207 |
Second Address | Spokane, WA 99207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2006 |
Last Update Date | 28/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
080143897 | RAILROAD MEDICARE (01) | WA |
1108281 | (05) | WA |
134530 | L & I (01) | |
G98203 | (02) |