Healthcare Provider Details

I. General information

NPI: 1235567959
Provider Name (Legal Business Name): RACHEL ELIZABETH COHEN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2013
Last Update Date: 10/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 COUNTRY CLUB RD SUITE 210B
EUGENE OR
97401-6024
US

IV. Provider business mailing address

PO BOX 742785
LOS ANGELES CA
90074-2785
US

V. Phone/Fax

Practice location:
  • Phone: 541-242-4172
  • Fax: 541-242-4171
Mailing address:
  • Phone: 541-687-4900
  • Fax: 541-684-3074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number60399
License Number StateOR

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: