Healthcare Provider Details

I. General information

NPI: 1316263775
Provider Name (Legal Business Name): RACHAEL KAIN L.M.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2010
Last Update Date: 04/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 NW MYHRE RD # 102
SILVERDALE WA
98383-7672
US

IV. Provider business mailing address

31698 SUNRISE BEACH CT NE
KINGSTON WA
98346-8676
US

V. Phone/Fax

Practice location:
  • Phone: 360-613-1834
  • Fax: 360-613-2716
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberMA60129771
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: