MEDICARE: MICHAEL RABOLD OTR/L

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
1	225X00000X	Occupational Therapist	OT60793007	WA

General Provider Information

NPI Number	:	1346601515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL RABOLD OTR/L

Provider Business Mailing Address
First Line	:	PO BOX 4825
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97208-4825
Country	:	US
Telephone Number	:	360-882-2778
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 NE 87TH AVE STE 350
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98664
Country	:	US
Telephone Number	:	360-882-2778
Fax Number	:	360-604-1757

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2016
Last Update Date	:	01/23/2026

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Directions to “ MICHAEL RABOLD OTR/L” Practice Location

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