Provider Demographics
NPI:1801523584
Name:MEEK, RACHEL ADA (DMD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ADA
Last Name:MEEK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ADA
Other - Last Name:WITTENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1685 SE UMATILLA ST APT 401
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-7242
Mailing Address - Country:US
Mailing Address - Phone:425-503-0402
Mailing Address - Fax:
Practice Address - Street 1:200 GWEE SHUT RD
Practice Address - Street 2:
Practice Address - City:SILETZ
Practice Address - State:OR
Practice Address - Zip Code:97380-2036
Practice Address - Country:US
Practice Address - Phone:541-444-9681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD11672122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist