Provider Demographics
NPI:1821301557
Name:GLIGOREA, RACHEL LYNN (MOTR/L)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:LYNN
Last Name:GLIGOREA
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:MRS
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:BOAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2540 NE SARATOGA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-5958
Mailing Address - Country:US
Mailing Address - Phone:503-575-6710
Mailing Address - Fax:
Practice Address - Street 1:2540 NE SARATOGA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-5958
Practice Address - Country:US
Practice Address - Phone:503-575-6710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR275532225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist