Provider Demographics
NPI:1902624307
Name:CARTER, RACHEL MADELEINE (MHCA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MADELEINE
Last Name:CARTER
Suffix:
Gender:F
Credentials:MHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8030 SW CAPITOL HILL RD # A
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-2683
Mailing Address - Country:US
Mailing Address - Phone:210-393-4478
Mailing Address - Fax:
Practice Address - Street 1:13505 NE 10TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-2711
Practice Address - Country:US
Practice Address - Phone:360-301-7434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61549287101YM0800X
ORR10051101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional