Provider Demographics
NPI:1295570711
Name:PHILLIPS, RACHEL S
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:S
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RAY
Other - Middle Name:
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2060 CHURCH ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-3702
Mailing Address - Country:US
Mailing Address - Phone:541-410-4248
Mailing Address - Fax:
Practice Address - Street 1:6444 FAIRWAY AVE SE STE 100
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-3073
Practice Address - Country:US
Practice Address - Phone:971-901-2731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator