Individual
RACHEL ALLISON DISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9135 SW BARNES RD STE 238, PORTLAND, OR 97225-6646
(503) 215-7920
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA207376
OR
363AS0400X
Surgical Physician Assistant
PA207376
OR
Other
Enumeration date
11/16/2021
Last updated
04/26/2022
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