Provider Demographics
NPI:1316263775
Name:KAIN, RACHAEL (LMP)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:KAIN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31698 SUNRISE BEACH CT NE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:WA
Mailing Address - Zip Code:98346-8676
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2400 NW MYHRE RD
Practice Address - Street 2:# 102
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7672
Practice Address - Country:US
Practice Address - Phone:360-613-1834
Practice Address - Fax:360-613-2716
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-10
Last Update Date:2010-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60129771171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor