1346509387 NPI number — DR. RACHEL MELISSA KNOX M.D.

Table of content: DR. RACHEL MELISSA KNOX M.D. (NPI 1346509387)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346509387 NPI number — DR. RACHEL MELISSA KNOX M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KNOX
Provider First Name:
RACHEL
Provider Middle Name:
MELISSA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346509387
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9900 SW GREENBURG RD
Provider Second Line Business Mailing Address:
SUITE 235
Provider Business Mailing Address City Name:
TIGARD
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97223
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-304-7000
Provider Business Mailing Address Fax Number:
704-304-7008

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9900 SW GREENBURG RD
Provider Second Line Business Practice Location Address:
SUITE 235
Provider Business Practice Location Address City Name:
TIGARD
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-304-7000
Provider Business Practice Location Address Fax Number:
704-304-7008
Provider Enumeration Date:
05/11/2012

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: 207Q00000X , with the licence number:  2014-02349 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 183450 . This is a "RTL - RESIDENT TRAINING LICENSE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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