Healthcare Provider Details

I. General information

NPI: 1235809740
Provider Name (Legal Business Name): RACHAEL MAY HART PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 NE HOYT ST STE 514
PORTLAND OR
97213-2984
US

IV. Provider business mailing address

541 NE 20TH AVE STE 225
PORTLAND OR
97232-2895
US

V. Phone/Fax

Practice location:
  • Phone: 503-488-2323
  • Fax: 503-488-2340
Mailing address:
  • Phone: 503-963-2801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA228988
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: