Provider Demographics
NPI:1164906442
Name:EDER, RACHEL (PTA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:EDER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 NUMBER 2 CANYON RD APT C
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-7346
Mailing Address - Country:US
Mailing Address - Phone:503-510-5247
Mailing Address - Fax:
Practice Address - Street 1:800 EASTMONT AVE
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-4458
Practice Address - Country:US
Practice Address - Phone:095-884-7169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty