Provider Demographics
NPI:1396867719
Name:STREU, RACHEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:E
Last Name:STREU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9775 SW WILSHIRE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5067
Mailing Address - Country:US
Mailing Address - Phone:503-646-0101
Mailing Address - Fax:503-350-1420
Practice Address - Street 1:9775 SW WILSHIRE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5067
Practice Address - Country:US
Practice Address - Phone:503-646-0101
Practice Address - Fax:503-350-1420
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD1621012086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500663836Medicaid
ORR185475Medicare PIN