Provider Demographics
NPI:1124439872
Name:KANG, RACHEL BAISCH (DPM)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:BAISCH
Last Name:KANG
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:KIM
Other - Last Name:BAISCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6947 COAL CREEK PKWY SE # 753
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98059-3136
Mailing Address - Country:US
Mailing Address - Phone:425-947-2880
Mailing Address - Fax:800-554-8144
Practice Address - Street 1:13114 120TH AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3014
Practice Address - Country:US
Practice Address - Phone:425-947-2880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1090213E00000X
WAPO60720228213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist