Provider Demographics
NPI:1184679789
Name:DOW, RAECHELLE LIANNE (APRN PNP)
Entity Type:Individual
Prefix:MRS
First Name:RAECHELLE
Middle Name:LIANNE
Last Name:DOW
Suffix:
Gender:F
Credentials:APRN PNP
Other - Prefix:MS
Other - First Name:RAECHELLE
Other - Middle Name:LIANNE
Other - Last Name:DOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN PNP
Mailing Address - Street 1:955 POWELL AVE SW
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2908
Mailing Address - Country:US
Mailing Address - Phone:425-277-1311
Mailing Address - Fax:425-277-1566
Practice Address - Street 1:225 S 152ND ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98148-1005
Practice Address - Country:US
Practice Address - Phone:206-870-3623
Practice Address - Fax:206-299-3496
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61395731163W00000X
CARN5658145163W00000X
CANP15667363L00000X
WAAP61395734363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ72082Medicare UPIN