Basic Information
| Provider Information | |||||||||
| NPI: | 1548633167 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARTIN | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | |||||||||
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| Credential: | RD, LD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | SALOMAN | ||||||||
| OtherFirstName: | RACHEL | ||||||||
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| OtherCredential: | RD, LD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 7008 NE RONLER WAY 3238 | ||||||||
| Address2: | |||||||||
| City: | HILLSBORO | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9787612368 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2801 N GANTENBEIN AVE | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972271873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032766500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2015 | ||||||||
| LastUpdateDate: | 11/28/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133VN1004X | LD-D-10188736 | OR | N | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Pediatric | 133V00000X | LD-D-10188736 | OR | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.