Provider Demographics
NPI:1477228849
Name:RAYMOND, RACHEL ANN (RDN, RD)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ANN
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:RDN, RD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ANN
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5210 E HAMPTON AVE APT 2113
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-3463
Mailing Address - Country:US
Mailing Address - Phone:435-590-1465
Mailing Address - Fax:
Practice Address - Street 1:6124 E BROWN RD STE 102
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-4959
Practice Address - Country:US
Practice Address - Phone:480-809-6513
Practice Address - Fax:480-809-6823
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ133V00000X
AZ86198189133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered