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General NPI Number Information
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NPI Number | 1457854754
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Entity Type | Individual
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Provider Name | RACHEL ELISABETH BRIDWELL MD
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Gender | Female
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Dates
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Enumeration Date | 03/13/2018
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 9040 JACKSON AVE
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City | TACOMA
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State | WA
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Zip | 98431-4504
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Country | US
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Telephone | 253-968-2252
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Fax |
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Provider Business Mailing Address
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Address Line | 13268 SLEEPY HOLLOW LN
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City | KING GEORGE
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State | VA
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Zip | 22485-4959
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 61249276
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD61249276
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 0101267983
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License Number State | VA
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