Healthcare Provider Details

I. General information

NPI: 1184577710
Provider Name (Legal Business Name): RACHEL SOPHIA HABBAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UW DEPARTMENT OF ORAL SURGEY 1959 NE PACIFIC STREET; BOX 357134
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

134 AUGUSTA DR
PALOS HEIGHTS IL
60463-2905
US

V. Phone/Fax

Practice location:
  • Phone: 708-954-6090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEUW.DR.70103415
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: