Healthcare Provider Details

I. General information

NPI: 1386349579
Provider Name (Legal Business Name): RACHEL CANTRELL GALLAGHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9290 SE SUNNYBROOK BLVD STE 120
CLACKAMAS OR
97015-6802
US

IV. Provider business mailing address

9290 SE SUNNYBROOK BLVD STE 120
CLACKAMAS OR
97015-6802
US

V. Phone/Fax

Practice location:
  • Phone: 503-215-2110
  • Fax:
Mailing address:
  • Phone: 503-215-2110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD230656
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: