Provider Demographics
NPI:1629348461
Name:SOWERS, RACHEL ELIZABETH (PT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:SOWERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4613 W MAIN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-2645
Mailing Address - Country:US
Mailing Address - Phone:269-488-8360
Mailing Address - Fax:269-488-8359
Practice Address - Street 1:1200 NE 48TH AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-4904
Practice Address - Country:US
Practice Address - Phone:503-681-4317
Practice Address - Fax:503-693-2330
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015794225100000X
OR603652251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI650C903670OtherBCBS
MI650C903670OtherBCBS