Provider Demographics
NPI:1659913242
Name:GARRY, RACHEL FRANCES (FNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:FRANCES
Last Name:GARRY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12249 SE OATFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-6952
Mailing Address - Country:US
Mailing Address - Phone:845-820-0864
Mailing Address - Fax:
Practice Address - Street 1:12249 SE OATFIELD RD
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6952
Practice Address - Country:US
Practice Address - Phone:845-820-0864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-15
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201605015RN163WE0003X
OR202205040NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency