Healthcare Provider Details

I. General information

NPI: 1548299274
Provider Name (Legal Business Name): RACHEL V WALDEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 03/07/2023
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 N BINKLEY ST SUITE 101
SOLDOTNA AK
99669-7500
US

IV. Provider business mailing address

250 HOSPITAL PL
SOLDOTNA AK
99669-7559
US

V. Phone/Fax

Practice location:
  • Phone: 907-714-4111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberM2493
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM2493
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: