Provider Demographics
NPI:1336456268
Name:PIPE, RACHEL JOY (AUD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:JOY
Last Name:PIPE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:JOY
Other - Last Name:VANKLOMPENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:100 MICHIGAN ST NE
Mailing Address - Street 2:MC 845
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:616-288-3732
Mailing Address - Fax:616-288-9857
Practice Address - Street 1:588 E LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-2023
Practice Address - Country:US
Practice Address - Phone:616-288-3732
Practice Address - Fax:616-288-9857
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
237600000X
MI1601000567231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
M74460270Medicare PIN