Provider Demographics
NPI:1336563774
Name:CRAIG, RACHEL F (LMT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:F
Last Name:CRAIG
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 NW FEDERAL ST
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-2336
Mailing Address - Country:US
Mailing Address - Phone:541-977-1984
Mailing Address - Fax:
Practice Address - Street 1:1345 NW FEDERAL ST
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-2336
Practice Address - Country:US
Practice Address - Phone:541-977-1984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7495225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist