Provider Demographics
NPI:1073699872
Name:BEDA, RACHEL DONAHUE
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DONAHUE
Last Name:BEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 23RD AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-3536
Mailing Address - Country:US
Mailing Address - Phone:206-949-5044
Mailing Address - Fax:
Practice Address - Street 1:613 19TH AVE E STE 201
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4000
Practice Address - Country:US
Practice Address - Phone:206-466-5937
Practice Address - Fax:206-535-8844
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042592207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8396129Medicaid
219560OtherINTERNAL ID-MOTOR VEHICLE ID
219560OtherINTERNAL ID-MOTOR VEHICLE ID
WA8396129Medicaid
8804267Medicare ID - Type Unspecified