Provider Demographics
NPI:1356102784
Name:RICH, REBECCA HELEN (MSCN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:HELEN
Last Name:RICH
Suffix:
Gender:F
Credentials:MSCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13850 SW FANNO CREEK DR APT 9
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8127
Mailing Address - Country:US
Mailing Address - Phone:757-839-2664
Mailing Address - Fax:
Practice Address - Street 1:13850 SW FANNO CREEK DR APT 9
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8127
Practice Address - Country:US
Practice Address - Phone:757-839-2664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist