Individual
RACHEL SHADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2204 PACIFIC AVE N, LONG BEACH, WA 98631-3300
(360) 642-3787
Mailing address
PO BOX 1155, SOUTH BEND, WA 98586-1155
(425) 563-0413
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CM60602536
STATE CERTIFICATION
WA
Enumeration date
07/27/2021
Last updated
09/27/2021
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