Provider Demographics
NPI:1326247818
Name:MAIDEN, RACHEL ELIZABETH
Entity Type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:MAIDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4711 SE SALQUIST RD
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-9118
Mailing Address - Country:US
Mailing Address - Phone:503-975-0837
Mailing Address - Fax:
Practice Address - Street 1:2375 NW GLISAN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3420
Practice Address - Country:US
Practice Address - Phone:503-243-2236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR372600000XOtherNURSING SERVICES RELATED