Provider Demographics
NPI:1508393133
Name:ENTREKIN, RACHEL LAUREN (DPT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LAUREN
Last Name:ENTREKIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26367 CONIFER RD STE A
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-9137
Mailing Address - Country:US
Mailing Address - Phone:303-838-3900
Mailing Address - Fax:
Practice Address - Street 1:26367 CONIFER RD STE A
Practice Address - Street 2:
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-9137
Practice Address - Country:US
Practice Address - Phone:303-838-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-14
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299847225100000X
2251X0800X
WAPT60747668225100000X
COCP036868T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2154849Medicaid
1508393133OtherN/A