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

Table of content: DR. RACHEL ERIN CHAO ED.D., CCC-SLP (NPI 1154688190)

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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