Basic Information
Provider Information
NPI: 1588102107
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANKLIN
FirstName: RACHEL
MiddleName: LEE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 421
Address2:  
City: LIBERTY LAKE
State: WA
PostalCode: 990190421
CountryCode: US
TelephoneNumber: 5098938140
FaxNumber:  
Practice Location
Address1: 1212 N PINES RD
Address2:  
City: SPOKANE VALLEY
State: WA
PostalCode: 992064939
CountryCode: US
TelephoneNumber: 5098938140
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/02/2017
LastUpdateDate: 05/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X193591TNN Nursing Service ProvidersRegistered Nurse 
363L00000XAP60735452WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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