Provider Demographics
NPI:1538525753
Name:COOK, RACHAEL (LM CPM)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:LM CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 STATE AVE NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-4065
Mailing Address - Country:US
Mailing Address - Phone:360-701-1418
Mailing Address - Fax:360-252-6160
Practice Address - Street 1:1026 STATE AVE NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-4065
Practice Address - Country:US
Practice Address - Phone:360-701-1418
Practice Address - Fax:360-252-6160
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-04
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA57361026176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1114382934OtherGROUP NPI