Provider Demographics
NPI:1538290820
Name:RAHN, GREGORY
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:RAHN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 NICHOLS RD
Mailing Address - Street 2:
Mailing Address - City:OMAK
Mailing Address - State:WA
Mailing Address - Zip Code:98841-9771
Mailing Address - Country:US
Mailing Address - Phone:503-538-9368
Mailing Address - Fax:
Practice Address - Street 1:105 NICHOLS RD
Practice Address - Street 2:
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841-9771
Practice Address - Country:US
Practice Address - Phone:503-538-9368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG32754207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology