TREVOR SCOTT RACHKO (NPI# 1598316572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1598316572 |
Entity Type | Individual |
Full Name | TREVOR SCOTT RACHKO |
Credential | PMHNP, MSN |
Practice Address |
1410 Ne 106th Ave Portland OR 97220-3934 |
Mailing Address |
2985 Ne Moda Way Apt 317 Hillsboro OR 97124-7019 |
Practice Telephone | 5034600405 |
Practice Fax Number | 5034600434 |
Mailing Telephone | 5037011679 |
Enumeration Date | 2019-09-22 |
Last Update Date | 2019-11-21 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
201909432NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1410 NE 106TH AVE |
City | PORTLAND |
State | OR |
Zip Code | 97220-3934 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316017585 | Theresa Bunker | Nurse Practitioner | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2006-11-08 |
1558975151 | Amber Rae Oyama | Clinic/Center | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2020-09-02 |
1912540980 | Kyle Edward Anderson | Nurse Practitioner | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2019-10-23 |
1801449301 | Eva Cicilian | Registered Nurse | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2019-07-23 |
1891128005 | Neisha Caldwell | Counselor | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2013-08-12 |
1659622454 | Elizabeth Jane Sadock | Psychologist | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2012-09-20 |
1366751638 | Brittany Lyn Kolluru | Naturopath | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2010-10-04 |
1659604825 | Marti L Baird | Nurse Practitioner | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2009-09-04 |
1164576617 | Gwyneth Theresa Jones | Nurse Practitioner | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2007-01-22 |
1548330715 | Bridge City Family Medical Clinic, PC | Clinic/Center | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2006-11-08 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
Find all providers in zip 97220 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
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1154920148 | Hardcore Happy LLC | Nurse Practitioner | 740 Ne 116th Ct, Portland, OR 97220-2223 | 2020-10-20 |
1457967325 | Megan L Langworthy | Nurse Practitioner | 1914 Se 46th Ave, Portland, OR 97215-3148 | 2020-09-16 |
1104446681 | Skycloud Psychiatry LLC | Nurse Practitioner | 106 South West Woods St, Portland, OR 97201 | 2020-04-24 |
1730712290 | Lucy Anne Bloedon | Nurse Practitioner | 4020 Sw Iowa St, Portland, OR 97221-3423 | 2020-02-12 |
1346802733 | Compass Psychiatric Wellness LLC | Nurse Practitioner | 4300 Ne Fremont St Ste 260, Portland, OR 97213-1100 | 2019-07-05 |
1548721871 | Cooke Therapy Pllc | Nurse Practitioner | 1125 Se Madison St Ste 102, Portland, OR 97214-3600 | 2019-03-28 |
1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
1467969220 | Nw Mind-body Wellness, LLC | Nurse Practitioner | 16986 Nw Lynch Ln, Portland, OR 97229-1221 | 2018-01-02 |
1811441348 | Anthony Hoy | Nurse Practitioner | 5562 Se Pine St, Portland, OR 97215-1276 | 2016-08-12 |
1700241254 | Jacqueline J Cole | Nurse Practitioner | 5228 Ne Hoyt St Ste 300, Portland, OR 97213-3055 | 2015-12-29 |
Find all providers in PORTLAND |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.