Provider Demographics
NPI:1124400767
Name:SCHULZ, RACHEL (RDH)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 NE 97TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-9448
Mailing Address - Country:US
Mailing Address - Phone:360-831-1007
Mailing Address - Fax:
Practice Address - Street 1:10535 NE GLISAN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-4077
Practice Address - Country:US
Practice Address - Phone:360-831-1007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH6832124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist