Provider Demographics
NPI:1831563212
Name:HNIZDIL, RACHEL (MS QMHP LMFTI)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HNIZDIL
Suffix:
Gender:F
Credentials:MS QMHP LMFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15100 BOONES FERRY RD
Mailing Address - Street 2:SUITE 800B
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-3469
Mailing Address - Country:US
Mailing Address - Phone:971-832-9139
Mailing Address - Fax:
Practice Address - Street 1:15100 BOONES FERRY RD
Practice Address - Street 2:SUITE 800B
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3469
Practice Address - Country:US
Practice Address - Phone:971-832-9139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-22
Last Update Date:2018-07-31
Deactivation Date:2018-05-07
Deactivation Code:
Reactivation Date:2018-07-31
Provider Licenses
StateLicense IDTaxonomies
ORR3699106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist