Provider Demographics
NPI:1366793093
Name:RATZLAFF, REBEKAH JEANETTE (PSYD)
Entity type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:JEANETTE
Last Name:RATZLAFF
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 ESTHER ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-9529
Mailing Address - Country:US
Mailing Address - Phone:800-333-3712
Mailing Address - Fax:
Practice Address - Street 1:222 SE 8TH AVE STE 212
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4218
Practice Address - Country:US
Practice Address - Phone:503-352-7333
Practice Address - Fax:971-266-2956
Is Sole Proprietor?:No
Enumeration Date:2012-09-20
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2382103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical