Provider Demographics
NPI:1962975284
Name:NOLAN, RACHEL MARIE (RN)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:MARIE
Last Name:NOLAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18235 S CHARLIE CT
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-8806
Mailing Address - Country:US
Mailing Address - Phone:503-333-9767
Mailing Address - Fax:
Practice Address - Street 1:10330 SE 32ND AVE STE 110
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6596
Practice Address - Country:US
Practice Address - Phone:503-513-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR207QG0300X207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine