Provider Demographics
NPI:1396813119
Name:BEYER, RACHAEL M (RD)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:M
Last Name:BEYER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:M
Other - Last Name:FREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31980 BERLIN RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-9793
Mailing Address - Country:US
Mailing Address - Phone:541-451-2984
Mailing Address - Fax:
Practice Address - Street 1:665 WINTER STREET SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97309-5014
Practice Address - Country:US
Practice Address - Phone:503-516-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR713133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered