Provider Demographics
NPI:1780980490
Name:BARKER, RACHAEL (OD)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:BARKER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4129 JAMES CIR
Mailing Address - Street 2:
Mailing Address - City:ARDEN HILLS
Mailing Address - State:MN
Mailing Address - Zip Code:55112-1923
Mailing Address - Country:US
Mailing Address - Phone:425-941-1582
Mailing Address - Fax:
Practice Address - Street 1:7884 MAIN ST N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-7081
Practice Address - Country:US
Practice Address - Phone:763-420-6981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3837152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist