Healthcare Provider Details

I. General information

NPI: 1194482257
Provider Name (Legal Business Name): RACHEL ROTTGER DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2021
Last Update Date: 02/01/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 D ST SW
TUMWATER WA
98501-4064
US

IV. Provider business mailing address

128 D ST SW
TUMWATER WA
98501-4064
US

V. Phone/Fax

Practice location:
  • Phone: 360-570-9580
  • Fax: 360-570-9583
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH61248732
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: