Provider Demographics
NPI:1578253043
Name:RECTOR, CHANTEL NIKOLE
Entity Type:Individual
Prefix:
First Name:CHANTEL
Middle Name:NIKOLE
Last Name:RECTOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 N OAK HARBOR ST TRLR 56
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-5989
Mailing Address - Country:US
Mailing Address - Phone:360-929-1449
Mailing Address - Fax:
Practice Address - Street 1:955 3RD ST STE 201
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:WA
Practice Address - Zip Code:98230-4057
Practice Address - Country:US
Practice Address - Phone:206-751-6155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician