Provider Demographics
NPI:1013656214
Name:BOLLENS, RACHEL RYAN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:RYAN
Last Name:BOLLENS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 NE 73RD ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-5724
Mailing Address - Country:US
Mailing Address - Phone:206-265-0012
Mailing Address - Fax:
Practice Address - Street 1:9650 15TH AVE SW STE 100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98106-2576
Practice Address - Country:US
Practice Address - Phone:206-965-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61155430163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn