Provider Demographics
NPI:1811139355
Name:RAINIER, MICHELE
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:
Last Name:RAINIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6411 N ALBINA AVE
Mailing Address - Street 2:#8
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-1800
Mailing Address - Country:US
Mailing Address - Phone:503-234-7127
Mailing Address - Fax:
Practice Address - Street 1:2410 SE 121ST AVE
Practice Address - Street 2:#216
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-4066
Practice Address - Country:US
Practice Address - Phone:503-335-5975
Practice Address - Fax:503-335-5974
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor