Provider Demographics
NPI:1295492924
Name:COSGROVE, RACHEL (APRN, NP-C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:COSGROVE
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:MICHELLE
Other - Last Name:SEIBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8060 SW PFAFFLE ST STE 102
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8489
Mailing Address - Country:US
Mailing Address - Phone:503-714-8987
Mailing Address - Fax:
Practice Address - Street 1:8060 SW PFAFFLE ST STE 102
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8489
Practice Address - Country:US
Practice Address - Phone:503-714-8987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-17
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202108403NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily