Provider Demographics
NPI:1760719108
Name:PELTO, RACHEL A (ARNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:PELTO
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 1:1101 MADISON ST STE 1150
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3558
Mailing Address - Country:US
Mailing Address - Phone:206-386-3400
Mailing Address - Fax:206-386-3411
Practice Address - Street 1:1101 MADISON ST STE 1150
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3558
Practice Address - Country:US
Practice Address - Phone:206-386-3400
Practice Address - Fax:206-386-3411
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60119761363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP60119761OtherWA STATE ARNP LICENSE