Provider Demographics
NPI:1124591086
Name:WHITE, RACHEL B (LMT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:B
Last Name:WHITE
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 1:251 W BROADWAY APT 151
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2882
Mailing Address - Country:US
Mailing Address - Phone:171-446-9502
Mailing Address - Fax:
Practice Address - Street 1:115 W 8TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2973
Practice Address - Country:US
Practice Address - Phone:541-343-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20173225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist