Provider Demographics
NPI:1609568872
Name:BASHAW, RACHEAL (DNP PMHNP)
Entity type:Individual
Prefix:
First Name:RACHEAL
Middle Name:
Last Name:BASHAW
Suffix:
Gender:F
Credentials:DNP PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CENTRAL AVE STE 321
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3128
Mailing Address - Country:US
Mailing Address - Phone:406-692-3276
Mailing Address - Fax:
Practice Address - Street 1:410 CENTRAL AVE STE 321
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3128
Practice Address - Country:US
Practice Address - Phone:406-692-3276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-217983363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health