Provider Demographics
NPI:1003308545
Name:THOMSON, RACHEL ANN (MSW, LISWA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:THOMSON
Suffix:
Gender:F
Credentials:MSW, LISWA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ANN
Other - Last Name:CUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LMSW
Mailing Address - Street 1:220 W NORA AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-4847
Mailing Address - Country:US
Mailing Address - Phone:480-262-4086
Mailing Address - Fax:
Practice Address - Street 1:721 N PINES RD STE 102
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-5225
Practice Address - Country:US
Practice Address - Phone:509-892-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC608161341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1376848010Medicaid