Provider Demographics
NPI:1740448448
Name:O'CONNOR, RACHEL LOUISE (MD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:LOUISE
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19020 33RD AVE W STE 210
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4748
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:19020 33RD AVE W STE 210
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4748
Practice Address - Country:US
Practice Address - Phone:425-563-1500
Practice Address - Fax:425-563-1501
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-123232085R0202X
WAMD604036952085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA327391OtherL & I PROVIDER NUMBER
WA327393OtherL & I PROVIDER NUMBER
WA2031376Medicaid
WA327390OtherL & I PROVIDER NUMBER
ID1740448448Medicaid
WA327389OtherL & I PROVIDER NUMBER
WA327389OtherL & I PROVIDER NUMBER
WA327389OtherL & I PROVIDER NUMBER
WAG8925551Medicare PIN
WAP01290952Medicare PIN
WA2031376Medicaid
WAG8924138Medicare PIN
ID20004670Medicare PIN
WA327390OtherL & I PROVIDER NUMBER
ID1740448448Medicaid
WAG8924139Medicare PIN