MEDICARE: RACHEL LYNN FRASER 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	7475660-4201	UT
2	225X00000X	Occupational Therapist	OT61144302	WA

General Provider Information

NPI Number	:	1891026621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL LYNN FRASER OTR/L

Provider Business Mailing Address
First Line	:	804 WYMOUNT TER
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-2071
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	343 WELLSIAN WAY STE 103
Second Line	:
City	:	RICHLAND
State	:	WA
Zip	:	99352-4107
Country	:	US
Telephone Number	:	509-392-3773
Fax Number	:	509-362-9693

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

Provider Enumeration Date	:	01/19/2010
Last Update Date	:	12/15/2023

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