Healthcare Provider Details

I. General information

NPI: 1962282020
Provider Name (Legal Business Name): RACHEL N STEVENSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2023
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 SW US VETERANS HOSPITAL RD
PORTLAND OR
97239-3076
US

IV. Provider business mailing address

3455 SW US VETERANS HOSPITAL RD
PORTLAND OR
97239-3076
US

V. Phone/Fax

Practice location:
  • Phone: 760-521-0881
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number202213928RN
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number202213928RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: