Provider Demographics
NPI:1386818045
Name:RACHEL EPPINGA ND, LAC, INC.
Entity Type:Organization
Organization Name:RACHEL EPPINGA ND, LAC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:EPPINGA
Authorized Official - Suffix:
Authorized Official - Credentials:ND, LAC
Authorized Official - Phone:503-515-7352
Mailing Address - Street 1:3821 NE MLK BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-1114
Mailing Address - Country:US
Mailing Address - Phone:503-954-1660
Mailing Address - Fax:971-266-8183
Practice Address - Street 1:3821 NE MLK BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-1114
Practice Address - Country:US
Practice Address - Phone:503-954-1660
Practice Address - Fax:971-266-8183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00757171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1750334439OtherTYPE 1 NPI