Healthcare Provider Details

I. General information

NPI: 1689584690
Provider Name (Legal Business Name): RACHEL DIANE PERRIGO PCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 VILLAGE LOOP RD
KALISPELL MT
59901-2948
US

IV. Provider business mailing address

723 5TH AVE E STE B-18
KALISPELL MT
59901-5321
US

V. Phone/Fax

Practice location:
  • Phone: 406-249-5506
  • Fax: 406-890-6842
Mailing address:
  • Phone: 406-249-5506
  • Fax: 406-890-6842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberBBH-PCLC-LIC-90598
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: