Provider Demographics
NPI:1699566117
Name:WYNER, RACHEL (PA-C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WYNER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:17500 N 67TH AVE APT 1085
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1084
Mailing Address - Country:US
Mailing Address - Phone:562-242-8263
Mailing Address - Fax:
Practice Address - Street 1:3311 RIVERBEND DR STE 300
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-8800
Practice Address - Country:US
Practice Address - Phone:541-484-4332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-06-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant