Provider Demographics
NPI:1275856783
Name:CONE, RACHAEL ANN (LMT)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:ANN
Last Name:CONE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:A
Other - Last Name:DESSERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:412 JEFFERSON PKWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-1251
Mailing Address - Country:US
Mailing Address - Phone:971-237-7875
Mailing Address - Fax:
Practice Address - Street 1:412 JEFFERSON PKWY STE 204
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-1251
Practice Address - Country:US
Practice Address - Phone:971-237-7875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15816225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR15816OtherSTATE LICENSE