Provider Demographics
NPI:1104116946
Name:PEARCE, RACHEL (LAC)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:PEARCE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 NE CLAY AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-5153
Mailing Address - Country:US
Mailing Address - Phone:541-390-8184
Mailing Address - Fax:541-647-1282
Practice Address - Street 1:362 NE CLAY AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-5153
Practice Address - Country:US
Practice Address - Phone:541-390-8184
Practice Address - Fax:541-647-1282
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC153107171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORAC153107OtherOREGON MEDICAL BOARD