Provider Demographics
NPI:1003672320
Name:GREGG, RACHEL GINA (AA CPC)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:GINA
Last Name:GREGG
Suffix:
Gender:F
Credentials:AA CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MARTY SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:WAPATO
Mailing Address - State:WA
Mailing Address - Zip Code:98951-9541
Mailing Address - Country:US
Mailing Address - Phone:509-907-9299
Mailing Address - Fax:
Practice Address - Street 1:20 MARTY SOUTH DR
Practice Address - Street 2:
Practice Address - City:WAPATO
Practice Address - State:WA
Practice Address - Zip Code:98951-9541
Practice Address - Country:US
Practice Address - Phone:509-907-9299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1366634552101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor