Provider Demographics
NPI:1053199570
Name:FOX, RACHEL ANN (ATC, CPT)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:ANN
Last Name:FOX
Suffix:
Gender:F
Credentials:ATC, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 SE 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-7751
Mailing Address - Country:US
Mailing Address - Phone:503-756-4920
Mailing Address - Fax:
Practice Address - Street 1:909 SW 18TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-1705
Practice Address - Country:US
Practice Address - Phone:503-962-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR102113002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer