Provider Demographics
NPI:1568716249
Name:FIDINO, RACHEL MAE (ARNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MAE
Last Name:FIDINO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 S LOUISIANA ST STE A120
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-8630
Mailing Address - Country:US
Mailing Address - Phone:509-491-1944
Mailing Address - Fax:
Practice Address - Street 1:35 S LOUISIANA ST STE A120
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-8630
Practice Address - Country:US
Practice Address - Phone:509-491-1944
Practice Address - Fax:509-735-8474
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-02
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60287998363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health