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NPI Code Detail

MEDICARE: RACHAEL ANNETTE CHAMBERS EFDA

MEDICARE: RACHAEL ANNETTE CHAMBERS EFDA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1126800000XDental Assistant112057OR

General Provider Information

NPI Number : 1285724021
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHAEL ANNETTE CHAMBERS EFDA
Provider Business Mailing Address
First Line : 18909 SE GRANT ST
Second Line :
City : PORTLAND
State : OR
Zip : 97233
Country : US
Telephone Number : 503-492-1481
Fax Number :
Provider Business Practice Location Address
First Line : 7201 N INTERSTATE
Second Line : NORTH INTERSTATE DENTAL
City : PORTLAND
State : OR
Zip : 97217-5523
Country : US
Telephone Number : 503-240-4051
Fax Number : 503-240-4024
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2006
Last Update Date : 07/08/2007

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Directions to “ RACHAEL ANNETTE CHAMBERS EFDA” Practice Location

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