Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DE 60557223 | WA |
N | 1223D0001X | Dental Public Health | DE 60557223 | WA |
NPI | 1083027718 |
---|---|
Provider Name | Mrs. Rachel Suzanne Kramer |
First Address | Snoqualmie, WA 98065-8702 |
Second Address | Snoqualmie, WA 98065-6313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2014 |
Last Update Date | 05/11/2015 |