Provider Demographics
NPI:1003500620
Name:MUSICH, RACHEL LILLIAN (LMT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LILLIAN
Last Name:MUSICH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:ISOBEL
Other - Middle Name:LILLIAN
Other - Last Name:MUSICH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:10000 SW HALL BLVD UNIT 9
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8847
Mailing Address - Country:US
Mailing Address - Phone:360-310-7651
Mailing Address - Fax:
Practice Address - Street 1:10000 SW HALL BLVD UNIT 9
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8847
Practice Address - Country:US
Practice Address - Phone:360-310-7651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27718225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist