Provider Demographics
NPI:1346909918
Name:RAKOWSKI, ROCHELLE A (PHD)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:A
Last Name:RAKOWSKI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ROCHELLE
Other - Middle Name:A
Other - Last Name:PEGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:5045 GREENSBOROUGH CT
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8748
Mailing Address - Country:US
Mailing Address - Phone:503-235-5138
Mailing Address - Fax:
Practice Address - Street 1:5045 GREENSBOROUGH CT
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-8748
Practice Address - Country:US
Practice Address - Phone:503-235-5138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1311101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health