Healthcare Provider Details

I. General information

NPI: 1710823372
Provider Name (Legal Business Name): RINA ISRAEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11305 NW 95TH TER
YUKON OK
73099-7735
US

IV. Provider business mailing address

11305 NW 95TH TER
YUKON OK
73099-7735
US

V. Phone/Fax

Practice location:
  • Phone: 503-756-2759
  • Fax: 503-756-2759
Mailing address:
  • Phone: 503-756-2759
  • Fax: 503-756-2759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number7187167
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: