Provider Demographics
NPI:1881417434
Name:STOUT, RACHEL M
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:STOUT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 OAKCREST CT SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-1836
Mailing Address - Country:US
Mailing Address - Phone:360-536-2182
Mailing Address - Fax:
Practice Address - Street 1:200 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-9539
Practice Address - Country:US
Practice Address - Phone:360-536-2182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program