Provider Demographics
NPI:1316757792
Name:MACKRIELL, RACHEL MARLOW (CNM ARNP)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:MARLOW
Last Name:MACKRIELL
Suffix:
Gender:F
Credentials:CNM ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 S 50TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98408-5707
Mailing Address - Country:US
Mailing Address - Phone:253-304-3208
Mailing Address - Fax:
Practice Address - Street 1:4300 TALBOT RD S STE 402
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6238
Practice Address - Country:US
Practice Address - Phone:425-207-8769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61622529367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife