Provider Demographics
NPI:1376020115
Name:BASOLO, RACHEL DIANE (BIRTH DOULA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DIANE
Last Name:BASOLO
Suffix:
Gender:F
Credentials:BIRTH DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 FILBERT AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-3000
Mailing Address - Country:US
Mailing Address - Phone:541-510-4631
Mailing Address - Fax:
Practice Address - Street 1:820 FILBERT AVE APT 1
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-3000
Practice Address - Country:US
Practice Address - Phone:541-510-4631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-24
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula