Provider Demographics
NPI:1417670233
Name:STUBBLEFIELD, RACHAEL (RN)
Entity Type:Individual
Prefix:MS
First Name:RACHAEL
Middle Name:
Last Name:STUBBLEFIELD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 N 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-4100
Mailing Address - Country:US
Mailing Address - Phone:509-547-5581
Mailing Address - Fax:509-546-2684
Practice Address - Street 1:1108 N 10TH AVE
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-4100
Practice Address - Country:US
Practice Address - Phone:509-547-5581
Practice Address - Fax:509-546-2684
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60226653163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool