Provider Demographics
NPI:1093504334
Name:DUKES, RACHEL MADISON
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MADISON
Last Name:DUKES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19301 90TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-6497
Mailing Address - Country:US
Mailing Address - Phone:352-209-8951
Mailing Address - Fax:
Practice Address - Street 1:19301 90TH AVENUE CT E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-6497
Practice Address - Country:US
Practice Address - Phone:352-209-8951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-03
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1332732106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician