Healthcare Provider Details

I. General information

NPI: 1902340854
Provider Name (Legal Business Name): RACHEL HOLLOWELL LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2016
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2207 E TUDOR RD STE 33
ANCHORAGE AK
99507-1069
US

IV. Provider business mailing address

2207 E TUDOR RD STE 33
ANCHORAGE AK
99507-1069
US

V. Phone/Fax

Practice location:
  • Phone: 907-376-8020
  • Fax: 907-782-4148
Mailing address:
  • Phone: 907-519-8049
  • Fax: 907-782-4148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number454716080
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: