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General NPI Number Information
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NPI Number | 1154076354
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Entity Type | Individual
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Provider Name | RACHEL WATKINS PTA
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Gender | Female
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Dates
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Enumeration Date | 02/16/2022
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 500 5TH ST
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City | BROOKINGS
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State | OR
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Zip | 97415-9702
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Country | US
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Telephone | 541-412-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1625 SAN BONIFACIO ARC
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City | LAS CRUCES
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State | NM
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Zip | 88005-4006
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Country | US
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Telephone | 719-304-9568
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 9913
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 51944
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License Number State | CA
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