Individual
MRS. ALICE RACHEL YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2045
(541) 267-1515
(541) 266-4501
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-2045
(541) 267-1515
(541) 266-4501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA152139
OR
363AM0700X
Medical Physician Assistant
PA152139
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407812365
NBMC GROUP NPI
OR
01
—
161133
NBMC GROUP MEDICAID
OR
01
—
93-0635514
NBMC GROUP TAX ID FOR BILLING
OR
01
—
PA152139
STATE OF OREGON
OR
01
—
R0000WFBTV
NBMC GROUP MEDICARE NUMBER
OR
Enumeration date
06/17/2010
Last updated
03/19/2026
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