Healthcare Provider Details

I. General information

NPI: 1659209906
Provider Name (Legal Business Name): MRS. RACHEL HURD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 NE FOGARTY ST
NEWPORT OR
97365-4978
US

IV. Provider business mailing address

1212 NE FOGARTY ST
NEWPORT OR
97365-4978
US

V. Phone/Fax

Practice location:
  • Phone: 541-265-9211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number545234
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: