Provider Demographics
NPI:1972807063
Name:SAMMIS-FALK, RACHEL LYNNE (PA-C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LYNNE
Last Name:SAMMIS-FALK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:L
Other - Last Name:SAMMIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:34509 9TH AVE S STE 204
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8708
Mailing Address - Country:US
Mailing Address - Phone:253-835-5510
Mailing Address - Fax:253-835-5511
Practice Address - Street 1:34509 9TH AVE S STE 204
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8708
Practice Address - Country:US
Practice Address - Phone:253-835-5510
Practice Address - Fax:253-835-5511
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60339273363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2032743Medicaid