Provider Demographics
NPI:1891836979
Name:RAHN, SUSAN A (PT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:A
Last Name:RAHN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18323 BOTHELL EVERETT HWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-5246
Mailing Address - Country:US
Mailing Address - Phone:425-806-5721
Mailing Address - Fax:425-806-5701
Practice Address - Street 1:15809 BEAR CREEK PKWY STE 101
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-1542
Practice Address - Country:US
Practice Address - Phone:425-882-6100
Practice Address - Fax:425-882-7690
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003812225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8336513Medicaid
WA8336513Medicaid