Provider Demographics
NPI:1063773604
Name:LOEBACH, RACHAEL C (DPT)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:C
Last Name:LOEBACH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1519 132ND ST SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-7203
Mailing Address - Country:US
Mailing Address - Phone:425-357-9380
Mailing Address - Fax:425-357-9382
Practice Address - Street 1:360 LILLY RD NE
Practice Address - Street 2:SUITE A
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5430
Practice Address - Country:US
Practice Address - Phone:360-486-0640
Practice Address - Fax:360-486-0641
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2020-04-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAPT60287914225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0295448OtherL & I
WAG8912907Medicare PIN