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Individual

RACHELLE MARIE ROULIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
19 MYRTLE ST, MEDFORD, OR 97504-7337
(541) 773-3863
(541) 776-2892
Mailing address
8385 DIVISION RD, WHITE CITY, OR 97503-1176
(541) 842-7626
(541) 842-7640

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
19601
CA
363AM0700X
Medical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
227698
OR
Enumeration date
03/02/2008
Last updated
03/07/2012
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