Provider Demographics
NPI:1588128763
Name:KOEHLER, RACHEL RENE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:RENE
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8515 NE HAZEL DELL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8144
Mailing Address - Country:US
Mailing Address - Phone:509-998-7874
Mailing Address - Fax:360-841-7049
Practice Address - Street 1:8515 NE HAZEL DELL AVE STE A
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8144
Practice Address - Country:US
Practice Address - Phone:509-998-7874
Practice Address - Fax:360-841-7049
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAL00004509235Z00000X
WALL00004509235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist