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NPI Code Detail

MEDICARE: RACHEAL PRISCO PSS,CRM

MEDICARE:   RACHEAL  PRISCO  PSS,CRM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer SpecialistOR

General Provider Information

NPI Number : 1245945823
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEAL PRISCO PSS,CRM
Provider Business Mailing Address
First Line : PO BOX 17818
Second Line :
City : SALEM
State : OR
Zip : 97305-7818
Country : US
Telephone Number : 503-363-2021
Fax Number :
Provider Business Practice Location Address
First Line : 380 E JEFFERSON ST
Second Line :
City : STAYTON
State : OR
Zip : 97383-1855
Country : US
Telephone Number : 503-363-2021
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2023
Last Update Date : 01/18/2023

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Directions to “ RACHEAL PRISCO PSS,CRM” Practice Location

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