Healthcare Provider Details

I. General information

NPI: 1205554128
Provider Name (Legal Business Name): CHLOE MARISSA EVA RABB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2022
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 LIBERTY ST NE
SALEM OR
97301-7330
US

IV. Provider business mailing address

3415 SE POWELL BLVD
PORTLAND OR
97202-3371
US

V. Phone/Fax

Practice location:
  • Phone: 541-729-1937
  • Fax:
Mailing address:
  • Phone: 503-798-3858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number29634
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: