1013010693 NPI number — MRS. RACHEL MAUREEN FRANK OTRL

Table of content: MRS. RACHEL MAUREEN FRANK OTRL (NPI 1013010693)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013010693 NPI number — MRS. RACHEL MAUREEN FRANK OTRL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRANK
Provider First Name:
RACHEL
Provider Middle Name:
MAUREEN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OTRL
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCNASSAR
Provider Other First Name:
RACHEL
Provider Other Middle Name:
MAUREEN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTRL
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1013010693
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1915 S GINGER STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORNELIUS
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97113
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-317-0625
Provider Business Mailing Address Fax Number:
503-368-6712

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
37315 3RD STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEHALEM
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97131-9634
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-368-6711
Provider Business Practice Location Address Fax Number:
503-368-6712
Provider Enumeration Date:
09/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  1071694 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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