MEDICARE: DR. RACHEL E PECK DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT60045927	WA

General Provider Information

NPI Number	:	1528305539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHEL E PECK DPT

Provider Business Mailing Address
First Line	:	3727 CALIFORNIA AVE SW
Second Line	:	SUITE 1A
City	:	SEATTLE
State	:	WA
Zip	:	98116-4303
Country	:	US
Telephone Number	:	206-938-0860
Fax Number	:	206-938-0866

Provider Business Practice Location Address
First Line	:	3727 CALIFORNIA AVE SW
Second Line	:	SUITE 1A
City	:	SEATTLE
State	:	WA
Zip	:	98116-4303
Country	:	US
Telephone Number	:	206-938-0860
Fax Number	:	206-938-0866

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2013
Last Update Date	:	09/06/2013

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