Provider Demographics
NPI:1558590521
Name:IACOBAZZI RIECAN, RACHEL ANTONINA (ND)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANTONINA
Last Name:IACOBAZZI RIECAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ANTONINA
Other - Last Name:IACOBAZZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:104 23RD AVE SE
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-4527
Mailing Address - Country:US
Mailing Address - Phone:253-268-2170
Mailing Address - Fax:253-268-0658
Practice Address - Street 1:104 23RD AVE SE
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-4527
Practice Address - Country:US
Practice Address - Phone:253-268-2170
Practice Address - Fax:253-268-0658
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT61357214175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath