Provider Demographics
NPI:1093575482
Name:KAHN, RACHEL ROGERS (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ROGERS
Last Name:KAHN
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 N WILLIAMS AVE APT 308
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-2054
Mailing Address - Country:US
Mailing Address - Phone:503-803-6276
Mailing Address - Fax:
Practice Address - Street 1:5208 NE 122ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-1074
Practice Address - Country:US
Practice Address - Phone:503-261-5535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR497225225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist