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NPI Code Detail

MEDICARE: ELLEN M RAK MD

MEDICARE: ELLEN M RAK MD
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
1207Q00000XFamily Medicine PhysicianMD00027527WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538211016
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN M RAK MD
Provider Business Mailing Address
First Line : PO BOX 34703
Second Line :
City : SEATTLE
State : WA
Zip : 98124-1703
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1400 N LAVENTURE RD
Second Line :
City : MOUNT VERNON
State : WA
Zip : 98273-2766
Country : US
Telephone Number : 605-428-9003
Fax Number : 360-542-8796
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2007
Last Update Date : 11/27/2023

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