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NPI Code Detail

MEDICARE: RACHEL RAE FUNK LMT

MEDICARE: RACHEL RAE FUNK LMT
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
1225700000XMassage Therapist

General Provider Information

NPI Number : 1598481509
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL RAE FUNK LMT
Provider Business Mailing Address
First Line : 6272 SW VALLEY CIR
Second Line :
City : BEAVERTON
State : OR
Zip : 97008-4643
Country : US
Telephone Number : 971-470-6014
Fax Number :
Provider Business Practice Location Address
First Line : 2343 SE TUALATIN VALLEY HWY
Second Line :
City : HILLSBORO
State : OR
Zip : 97123-7976
Country : US
Telephone Number : 503-336-3456
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2022
Last Update Date : 10/12/2022

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