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General NPI Number Information
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NPI Number | 1669135091
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Entity Type | Individual
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Provider Name | RABEYA SURAKA
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Gender | Female
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Dates
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Enumeration Date | 10/21/2021
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 3425 S 176TH ST UNIT 284
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City | SEATAC
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State | WA
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Zip | 98188-4044
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Country | US
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Telephone | 206-446-1272
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Fax |
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Provider Business Mailing Address
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Address Line | 3425 S 176TH ST UNIT 284
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City | SEATAC
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State | WA
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Zip | 98188-4044
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Country | US
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Telephone | 206-446-1272
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LP60909528
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN61456197
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License Number State | WA
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