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General NPI Number Information
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NPI Number | 1083813950
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Entity Type | Organization
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Legal Business Name | RAECHEL J. MASSIE
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 278 ROWE STREET 2ND FLOOR NORTH
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City | WHEELER
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State | OR
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Zip | 97147
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Country | US
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Telephone | 503-368-4978
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Fax | 503-368-4979
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Provider Business Mailing Address
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Address Line | PO BOX 278
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City | NEHALEM
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State | OR
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Zip | 97131-0278
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Country | US
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Telephone | 503-368-4978
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Fax | 503-368-4979
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MS. RAECHEL JENNIFER MASSIE
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Credential | M.P.T.
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Telephone | 503-368-4978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 2437
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License Number State | OR
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