Basic Information
| Provider Information | |||||||||
| NPI: | 1760719108 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PELTO | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 MADISON ST STE 1150 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981043558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063863400 | ||||||||
| FaxNumber: | 2063863411 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 MADISON ST STE 1150 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981043558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063863400 | ||||||||
| FaxNumber: | 2063863411 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2009 | ||||||||
| LastUpdateDate: | 11/05/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | AP60119761 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
ID Information
| ID | Type | State | Issuer | Description | AP60119761 | 01 | WA | WA STATE ARNP LICENSE | OTHER |