Most Relevant Information
Provider Data
| NPI Number: | 1003527201 |
| Provider Name: | RACHAEL TATKO |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | D-1114 |
Most Important Dates
| Enumeration Date: | 12/08/2022 |
| Last Updated: | 12/08/2022 |
Provider Practice Location
13900 W WAINWRIGHT DR
BOISE
ID
837135028
Practice Location Phone/Fax
| Phone: | 2084339424 |
| Fax: |
Provider Mailing Location
2533 N WING RD
STAR
ID
836695140
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |