Provider Demographics
NPI:1851563415
Name:MAHONEY, RACHEL JEANETTE (DMD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:JEANETTE
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 N 193RD CT
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3983
Mailing Address - Country:US
Mailing Address - Phone:206-940-1014
Mailing Address - Fax:
Practice Address - Street 1:2722 COLBY AVE
Practice Address - Street 2:STE. 318
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3557
Practice Address - Country:US
Practice Address - Phone:425-551-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLL 165-07122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist