Individual
WHITNEY RACHELLE COULTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3110 STATE ST, MEDFORD, OR 97504-8450
(541) 872-3580
Mailing address
1355 ROXY ANN RD, MEDFORD, OR 97504-8065
(541) 261-7123
(541) 825-9205
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201602008RN
OR
363L00000X
Nurse Practitioner
Primary
202111129NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500798345
—
OR
Enumeration date
08/23/2021
Last updated
01/14/2026
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