Provider Demographics
NPI:1154689875
Name:PINCETICH, RACHEL L (LMT)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:L
Last Name:PINCETICH
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 1:850 NE 81ST AVE
Mailing Address - Street 2:SUITE #208
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-6978
Mailing Address - Country:US
Mailing Address - Phone:503-290-4757
Mailing Address - Fax:
Practice Address - Street 1:850 NE 81ST AVE
Practice Address - Street 2:SUITE #208
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-6978
Practice Address - Country:US
Practice Address - Phone:503-290-4757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17150174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist