Provider Demographics
NPI:1689447393
Name:SANDS, RACHEL (RDN)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:SANDS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 S VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48875-1852
Mailing Address - Country:US
Mailing Address - Phone:616-430-3448
Mailing Address - Fax:
Practice Address - Street 1:206 S VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:MI
Practice Address - Zip Code:48875-1852
Practice Address - Country:US
Practice Address - Phone:616-430-3448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered