Healthcare Provider Details

I. General information

NPI: 1992152920
Provider Name (Legal Business Name): RACHEL FRANK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2016
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 NW COLORADO AVE
BEND OR
97703-3257
US

IV. Provider business mailing address

20766 NE SIERRA DR
BEND OR
97701-7174
US

V. Phone/Fax

Practice location:
  • Phone: 541-610-9036
  • Fax:
Mailing address:
  • Phone: 541-610-9036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL8193
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1992152920
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerINDIVIDUAL NPI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: