Provider Demographics
NPI:1245653815
Name:MOHR, RACHEL
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:MOHR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12200 SE MCLOUGHLIN BLVD
Mailing Address - Street 2:APT 15304
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-7281
Mailing Address - Country:US
Mailing Address - Phone:213-300-8927
Mailing Address - Fax:
Practice Address - Street 1:15804 SE 114TH AVE
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9034
Practice Address - Country:US
Practice Address - Phone:213-300-8927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-01
Last Update Date:2014-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20438172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist