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General NPI Number Information
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NPI Number | 1699566117
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Entity Type | Individual
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Provider Name | RACHEL WYNER PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 3311 RIVERBEND DR STE 300
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City | SPRINGFIELD
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State | OR
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Zip | 97477-8800
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Country | US
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Telephone | 541-484-4332
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Fax |
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Provider Business Mailing Address
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Address Line | 17500 N 67TH AVE APT 1085
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City | GLENDALE
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State | AZ
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Zip | 85308-1084
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Country | US
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Telephone | 562-242-8263
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA226070
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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