Provider Demographics
NPI:1407283765
Name:WALTS, RACHEL KRAUSKOPF (RN, BSN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:KRAUSKOPF
Last Name:WALTS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:SUSAN
Other - Last Name:KRAUSKOPF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1019 PACIFIC AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-4443
Mailing Address - Country:US
Mailing Address - Phone:253-597-4550
Mailing Address - Fax:253-497-4556
Practice Address - Street 1:1019 PACIFIC AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-4443
Practice Address - Country:US
Practice Address - Phone:253-597-4550
Practice Address - Fax:253-497-4556
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60404385163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management