Individual
RACHEL FORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PWS
Contact information
Practice address
16289 HIGHWAY 101 S STE A, BROOKINGS, OR 97415-8404
(541) 200-7302
(541) 254-9002
Mailing address
16289 HIGHWAY 101 S STE A, BROOKINGS, OR 97415-8404
(541) 200-7302
(541) 254-9002
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
246RP1900X
Phlebotomy Technician
—
OR
Other
Enumeration date
04/03/2026
Last updated
04/03/2026
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