Provider Demographics
NPI:1720481120
Name:SPADY, RACHEL (PA-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SPADY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8000 E MAPLEWOOD AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4727
Mailing Address - Country:US
Mailing Address - Phone:303-286-5067
Mailing Address - Fax:303-991-9953
Practice Address - Street 1:9195 GRANT STREET
Practice Address - Street 2:#300
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4386
Practice Address - Country:US
Practice Address - Phone:303-286-5067
Practice Address - Fax:303-991-9953
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2018-05-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WYPT616363AM0700X
COPA.0004408363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical