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General NPI Number Information
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NPI Number | 1659912327
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Entity Type | Individual
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Provider Name | RACHAEL A ROBERTSON NP
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Gender | Female
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Dates
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Enumeration Date | 10/03/2019
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 2705 E BURNSIDE ST STE 206
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City | PORTLAND
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State | OR
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Zip | 97214-1768
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Country | US
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Telephone | 503-868-2520
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Fax | 888-539-8781
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Provider Business Mailing Address
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Address Line | 3439 SE HAWTHORNE BLVD # 401
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City | PORTLAND
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State | OR
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Zip | 97214-5048
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Country | US
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Telephone | 503-868-2520
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Fax | 503-676-6168
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95175003
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10021163
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License Number State | OR
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