Individual
CHARLES EVAN RAHE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
51579 COLUMBIA RIVER HWY, STE 'I', SCAPPOOSE, OR 97056-8411
(503) 543-6164
(503) 543-6040
Mailing address
51579 COLUMBIA RIVER HWY, STE 'I', SCAPPOOSE, OR 97056-8411
(503) 543-6164
(503) 543-6040
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L1330
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
93119252597203 A004
TRICARE
—
01
—
OR03358
PACIFICARE
OR
Enumeration date
01/11/2006
Last updated
07/08/2007
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