Provider Demographics
NPI:1407900046
Name:SHEPARD, RACHEL ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5962
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-0911
Mailing Address - Country:US
Mailing Address - Phone:541-343-6445
Mailing Address - Fax:541-343-2442
Practice Address - Street 1:767 WILLAMETTE ST
Practice Address - Street 2:SUITE 301
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2952
Practice Address - Country:US
Practice Address - Phone:541-343-6445
Practice Address - Fax:541-343-2442
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1665103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling