Healthcare Provider Details

I. General information

NPI: 1255256814
Provider Name (Legal Business Name): JHASMINE ERIN RABARA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32124 9TH AVE S
FEDERAL WAY WA
98003-5919
US

IV. Provider business mailing address

32124 9TH AVE S
FEDERAL WAY WA
98003-5919
US

V. Phone/Fax

Practice location:
  • Phone: 253-561-5255
  • Fax:
Mailing address:
  • Phone: 253-561-5255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: