Provider Demographics
NPI:1477235349
Name:GAENG, RACHEL THERESE (MSOT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:THERESE
Last Name:GAENG
Suffix:
Gender:F
Credentials:MSOT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:THERESE
Other - Last Name:DAMERON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3801 CONNECTICUT AVE NW # 100
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-4530
Mailing Address - Country:US
Mailing Address - Phone:202-525-1641
Mailing Address - Fax:
Practice Address - Street 1:3801 CONNECTICUT AVE NW # 100
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-4530
Practice Address - Country:US
Practice Address - Phone:202-525-1641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XP0200X
MD10268225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics