Provider Demographics
NPI:1790132579
Name:RAINBOW NATURAL HEALTH CLINIC
Entity Type:Organization
Organization Name:RAINBOW NATURAL HEALTH CLINIC
Other - Org Name:CYNTHIA KOTARSKI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NATUROPATHIC PHYSICIAN, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:206-387-9461
Mailing Address - Street 1:409 15TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4504
Mailing Address - Country:US
Mailing Address - Phone:206-387-9461
Mailing Address - Fax:
Practice Address - Street 1:409 15TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4504
Practice Address - Country:US
Practice Address - Phone:206-387-9461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60342361175F00000X, 207Q00000X
WA1760835896175F00000X
WANT60618568175F00000X
WAMA60644517225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2050287Medicaid