Provider Demographics
NPI:1154037307
Name:RACHEL MONTAGUE, LLC
Entity type:Organization
Organization Name:RACHEL MONTAGUE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MONTAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:206-579-5583
Mailing Address - Street 1:PO BOX 1730
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1758
Mailing Address - Country:US
Mailing Address - Phone:206-579-5583
Mailing Address - Fax:
Practice Address - Street 1:209 OAK ST STE 207
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-2099
Practice Address - Country:US
Practice Address - Phone:541-579-8880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health