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General NPI Number Information
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NPI Number | 1467029884
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Entity Type | Individual
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Provider Name | ALEX AMMA RAUCHLE DDS
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Gender | Female
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 1608 PENNY LN
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City | WALLA WALLA
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State | WA
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Zip | 99362-4477
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Country | US
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Telephone | 415-419-4481
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Fax |
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Provider Business Mailing Address
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Address Line | 1399 SW JULIA ST
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City | COLLEGE PLACE
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State | WA
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Zip | 99324-5501
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Country | US
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Telephone | 415-419-4481
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D11569
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DE61230608
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License Number State | WA
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