Provider Demographics
NPI:1891990958
Name:MAAS, RACHEL LYNN (ARNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LYNN
Last Name:MAAS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12333 130TH LANE
Mailing Address - Street 2:#320
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3039
Mailing Address - Country:US
Mailing Address - Phone:425-899-0555
Mailing Address - Fax:425-899-1360
Practice Address - Street 1:12333 130TH LANE
Practice Address - Street 2:#320
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3039
Practice Address - Country:US
Practice Address - Phone:425-899-0555
Practice Address - Fax:425-899-1360
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007735363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9653304Medicaid