Provider Demographics
NPI:1477641454
Name:LEVY, RACHEL J (LMSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:J
Last Name:LEVY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 NE COUCH ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-3027
Mailing Address - Country:US
Mailing Address - Phone:971-533-6369
Mailing Address - Fax:
Practice Address - Street 1:1700 NW CIVIC DRIVE
Practice Address - Street 2:SUITE 310
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97201
Practice Address - Country:US
Practice Address - Phone:503-666-8832
Practice Address - Fax:503-669-8641
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0555331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical