Provider Demographics
NPI:1336605484
Name:MASTER, RACHEL MARIE (RD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:MASTER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:MARIE
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:2806 N ALVERNON WAY STE 500
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1567
Mailing Address - Country:US
Mailing Address - Phone:520-260-8012
Mailing Address - Fax:
Practice Address - Street 1:2806 N ALVERNON WAY STE 500
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1567
Practice Address - Country:US
Practice Address - Phone:520-260-8012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ86079751133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered