Healthcare Provider Details

I. General information

NPI: 1427470673
Provider Name (Legal Business Name): RACHEL FARNEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2014
Last Update Date: 11/24/2021
Certification Date: 11/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 LILLY RD NE
OLYMPIA WA
98506-5030
US

IV. Provider business mailing address

209 LILLY RD NE
OLYMPIA WA
98506-5030
US

V. Phone/Fax

Practice location:
  • Phone: 360-413-8250
  • Fax: 360-413-8830
Mailing address:
  • Phone: 604-138-1913
  • Fax: 360-413-8898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number557218
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP60911630
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: