Healthcare Provider Details

I. General information

NPI: 1760830988
Provider Name (Legal Business Name): RACHAEL MIGITA VALENTE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2016
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9315 GRAVELLY LAKE DR SW SUITE 306
LAKEWOOD WA
98499-1574
US

IV. Provider business mailing address

94-801 FARRINGTON HWY STE W2
WAIPAHU HI
96797-3149
US

V. Phone/Fax

Practice location:
  • Phone: 253-581-5200
  • Fax: 253-581-5203
Mailing address:
  • Phone: 808-680-9123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT60645176
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number4265
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: