Provider Demographics
NPI:1376052746
Name:BOCK, RACHEL SUNMI (FNP-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:SUNMI
Last Name:BOCK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:SUNMI
Other - Last Name:KOH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 34703
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1703
Mailing Address - Country:US
Mailing Address - Phone:253-681-6600
Mailing Address - Fax:253-681-6645
Practice Address - Street 1:31405 18TH AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5433
Practice Address - Country:US
Practice Address - Phone:536-816-6002
Practice Address - Fax:253-681-6645
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAP60844582363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily