Healthcare Provider Details

I. General information

NPI: 1568172666
Provider Name (Legal Business Name): RACHEL MUSSON OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2022
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 PEARL ST
BOULDER CO
80301-1123
US

IV. Provider business mailing address

2800 PEARL ST
BOULDER CO
80301-1123
US

V. Phone/Fax

Practice location:
  • Phone: 303-305-6872
  • Fax:
Mailing address:
  • Phone: 303-305-6872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0003868
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: