Provider Demographics
NPI:1841535093
Name:WALKER, RACHELLE ARIA (LAC)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:ARIA
Last Name:WALKER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:ARIA
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:PO BOX 1292
Mailing Address - Street 2:
Mailing Address - City:CANNON BEACH
Mailing Address - State:OR
Mailing Address - Zip Code:97110-1292
Mailing Address - Country:US
Mailing Address - Phone:503-436-2255
Mailing Address - Fax:888-653-7244
Practice Address - Street 1:1355 S HEMLOCK ST
Practice Address - Street 2:
Practice Address - City:CANNON BEACH
Practice Address - State:OR
Practice Address - Zip Code:97110-3055
Practice Address - Country:US
Practice Address - Phone:503-436-2255
Practice Address - Fax:888-653-7244
Is Sole Proprietor?:No
Enumeration Date:2012-11-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC167797171100000X
AK158171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist