Provider Demographics
NPI:1811337785
Name:SIDLAUSKAS, RACHEL P (MS)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:P
Last Name:SIDLAUSKAS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:RAE
Other - Middle Name:
Other - Last Name:SIDLAUSKAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:218 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-4812
Mailing Address - Country:US
Mailing Address - Phone:541-286-5363
Mailing Address - Fax:
Practice Address - Street 1:218 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4812
Practice Address - Country:US
Practice Address - Phone:541-286-5363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health