MEDICARE: DR. RACHEL L CRIDDLE DNP, FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP60236571	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	301497	OTHER	WA	L&I

General Provider Information

NPI Number	:	1033407804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHEL L CRIDDLE DNP, FNP

Provider Business Mailing Address
First Line	:	7901 SKANSIE AVE STE 145
Second Line	:
City	:	GIG HARBOR
State	:	WA
Zip	:	98335-8349
Country	:	US
Telephone Number	:	253-303-2328
Fax Number	:	888-440-3239

Provider Business Practice Location Address
First Line	:	7901 SKANSIE AVE STE 1457901
Second Line	:
City	:	GIG HARBOR
State	:	WA
Zip	:	98335-8349
Country	:	US
Telephone Number	:	253-303-2328
Fax Number	:	888-440-3239

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2011
Last Update Date	:	04/09/2025

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