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General NPI Number Information
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NPI Number | 1962698159
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Entity Type | Individual
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Provider Name | RACHEL ANDERSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 01/28/2015
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Provider Practice Location Address
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Address Line | 616 6TH ST
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City | BREMERTON
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State | WA
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Zip | 98337-1420
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Country | US
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Telephone | 360-377-3776
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 960
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City | BREMERTON
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State | WA
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Zip | 98337-0212
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Country | US
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Telephone | 360-475-6728
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 6348743-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD00048552
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License Number State | WA
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