Healthcare Provider Details

I. General information

NPI: 1306248455
Provider Name (Legal Business Name): RACHEL HOPKINS RAVARRA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2014
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1127 BROADWAY ST NE
SALEM OR
97301-1123
US

IV. Provider business mailing address

7515 FALCON CREST DR # 200
REDMOND OR
97756-5014
US

V. Phone/Fax

Practice location:
  • Phone: 415-360-3833
  • Fax: 628-234-2048
Mailing address:
  • Phone: 541-904-5216
  • Fax: 541-527-4347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL8341
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWI.LW.61618328
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: