Provider Demographics
NPI:1649046541
Name:KANG, RACHAEL HEYOUNG (PHARMD)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:HEYOUNG
Last Name:KANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 NE 67TH ST APT N409
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-5831
Mailing Address - Country:US
Mailing Address - Phone:614-354-2456
Mailing Address - Fax:
Practice Address - Street 1:8500 35TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-3606
Practice Address - Country:US
Practice Address - Phone:206-527-8373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61464864183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist