Provider Demographics
NPI:1750594511
Name:PATEL, RACHANA J
Entity type:Individual
Prefix:
First Name:RACHANA
Middle Name:J
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14215 SE PETROVITSKY RD
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-8983
Mailing Address - Country:US
Mailing Address - Phone:425-235-7772
Mailing Address - Fax:
Practice Address - Street 1:14215 SE PETROVITSKY RD
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-8983
Practice Address - Country:US
Practice Address - Phone:425-235-7772
Practice Address - Fax:425-226-8099
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00059646183500000X
NJ28RI03260600183500000X
MD17550183500000X
PARP442642183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist