1154688190 NPI number — DR. RACHEL ERIN CHAO ED.D., CCC-SLP

Table of content: MARIT ELISE THORSGARD M.D. (NPI 1841436383)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154688190 NPI number — DR. RACHEL ERIN CHAO ED.D., CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAO
Provider First Name:
RACHEL
Provider Middle Name:
ERIN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
ED.D., CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DROSSMAN
Provider Other First Name:
RACHEL
Provider Other Middle Name:
ERIN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, CCC-SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1154688190
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 108
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAPLE VALLEY
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98038-0108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-521-9024
Provider Business Mailing Address Fax Number:
425-657-0691

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4509 TALBOT RD S STE 105C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RENTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98055-6294
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-521-9024
Provider Business Practice Location Address Fax Number:
425-529-9211
Provider Enumeration Date:
04/16/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  LL60273420 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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