Healthcare Provider Details

I. General information

NPI: 1164015152
Provider Name (Legal Business Name): RACHAEL ANN SILVERBERG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2021
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040 JACKSON AVE
JOINT BASE LEWIS MCCHORD WA
98431-0001
US

IV. Provider business mailing address

711 N ADAMS ST
TACOMA WA
98406-4927
US

V. Phone/Fax

Practice location:
  • Phone: 845-701-2055
  • Fax:
Mailing address:
  • Phone: 845-701-2055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2023005795
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number2023005795
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: