Provider Demographics
NPI:1861042665
Name:WARD, RACHEL (RBAI)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:RBAI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 NW 169TH PL STE A300
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-7385
Mailing Address - Country:US
Mailing Address - Phone:503-747-2587
Mailing Address - Fax:503-746-6323
Practice Address - Street 1:1800 NW 169TH PL STE A300
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-7385
Practice Address - Country:US
Practice Address - Phone:503-747-2587
Practice Address - Fax:503-746-6323
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORABA-IN-10195923106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician