Individual
EDMOND J RAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6600
Mailing address
1100 9TH AVE, MS:M4-PA, SEATTLE, WA 98101-2756
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MD00019975
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039588
LABOR AND INDUSTRIES #
WA
01
—
020039454
RAILROAD MC#
WA
01
—
1487703799
MONTANA MEDICAID
WA
05
—
8332405
—
WA
05
—
MD784WA
—
AK
01
—
R038
BLUE SHIELD #
WA
01
—
US0861508
AETNA SPECIALIST PIN
WA
Enumeration date
01/09/2007
Last updated
02/22/2013
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