Healthcare Provider Details

I. General information

NPI: 1972046951
Provider Name (Legal Business Name): RACHEL ANNE REYES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2016
Last Update Date: 09/23/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16501 NE 33RD CT APT YY101
REDMOND WA
98052-9377
US

IV. Provider business mailing address

16150 NE 85TH ST STE 220
REDMOND WA
98052-3546
US

V. Phone/Fax

Practice location:
  • Phone: 702-266-7751
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWIA.SC.60985803
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: