Individual
MS. RAECHEL JENNIFER MASSIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.P.T.
Contact information
Practice address
278 ROWE STREET, WHEELER, OR 97147
(503) 368-4978
(503) 368-4979
Mailing address
PO BOX 278, NEHALEM, OR 97131-0278
(503) 368-4978
(503) 368-4979
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2437
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
920195896
REGENCE BLUE CROSS BLUE S
OR
Enumeration date
06/12/2007
Last updated
07/08/2007
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