Provider Demographics
NPI:1124549175
Name:LENTZ, RACHAEL MADELINE (LMT)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:MADELINE
Last Name:LENTZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 PORTWAY AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1288
Mailing Address - Country:US
Mailing Address - Phone:541-406-0849
Mailing Address - Fax:541-716-5274
Practice Address - Street 1:501 PORTWAY AVE STE 203
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1288
Practice Address - Country:US
Practice Address - Phone:541-406-0849
Practice Address - Fax:541-716-5274
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22465225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist