Healthcare Provider Details

I. General information

NPI: 1124813050
Provider Name (Legal Business Name): RACHEL ZUKOWSKI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2025
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 NE STUCKI AVE STE 305
HILLSBORO OR
97006-8041
US

IV. Provider business mailing address

5550 COLONY DR N
SAGINAW MI
48638-5732
US

V. Phone/Fax

Practice location:
  • Phone: 541-807-0690
  • Fax:
Mailing address:
  • Phone: 734-756-3947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL16302
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: