Healthcare Provider Details

I. General information

NPI: 1619276292
Provider Name (Legal Business Name): RACHEL ELIZABETH TERNAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL ELIZABETH GEHRING

II. Dates (important events)

Enumeration Date: 03/22/2011
Last Update Date: 03/12/2022
Certification Date: 03/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 NE 137TH AVE
VANCOUVER WA
98682-4933
US

IV. Provider business mailing address

7101 NE 137TH AVE
VANCOUVER WA
98682-4933
US

V. Phone/Fax

Practice location:
  • Phone: 360-944-4962
  • Fax:
Mailing address:
  • Phone: 360-944-4962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP7443
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD61158655
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: