=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275325227
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHEL MARIE MCCOWIN RN BSN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/17/2025
-----------------------------------------------------
Last Update Date | 05/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9500 NE GLEN HOLLOW DR
-----------------------------------------------------
City | NEWBERG
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97132-4618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-746-3334
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8308 NE 25TH AVE
-----------------------------------------------------
City | VANCOUVER
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98665-9730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-746-3334
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WG0000X
-----------------------------------------------------
Taxonomy Name | General Practice Registered Nurse
-----------------------------------------------------
License Number | 10035196
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------