Healthcare Provider Details

I. General information

NPI: 1093624686
Provider Name (Legal Business Name): RACHEL BOWEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 NE DEKUM ST
PORTLAND OR
97211-2926
US

IV. Provider business mailing address

45 FREMONT RD
SAN RAFAEL CA
94901-2603
US

V. Phone/Fax

Practice location:
  • Phone: 503-383-9589
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number29930
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: