MEDICARE: RACHEL SOPHIA HABBAL

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1184577710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL SOPHIA HABBAL

Provider Business Mailing Address
First Line	:	134 AUGUSTA DR
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-2905
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	UW DEPARTMENT OF ORAL SURGEY
Second Line	:	1959 NE PACIFIC STREET; BOX 357134
City	:	SEATTLE
State	:	WA
Zip	:	98195-0001
Country	:	US
Telephone Number	:	708-954-6090
Fax Number	:

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

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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