Provider Demographics
NPI:1871764985
Name:WOLFE-PETERSEN, RACHEL LYNNE (MOTR/L)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:LYNNE
Last Name:WOLFE-PETERSEN
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-1917
Mailing Address - Country:US
Mailing Address - Phone:503-873-1647
Mailing Address - Fax:503-779-2234
Practice Address - Street 1:240 PHELPS ST
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381-1927
Practice Address - Country:US
Practice Address - Phone:503-873-1647
Practice Address - Fax:503-779-2234
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR214239225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist