Provider Demographics
NPI:1285475681
Name:BROWN, RACHEL NOELLE
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:NOELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 365TH ST. S.
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:WA
Mailing Address - Zip Code:98580
Mailing Address - Country:US
Mailing Address - Phone:360-870-4652
Mailing Address - Fax:
Practice Address - Street 1:615 E PIONEER STE 103
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3317
Practice Address - Country:US
Practice Address - Phone:727-457-8286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61551367207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine