Provider Demographics
NPI:1730364563
Name:PULVER, RACHEL (RN, FNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:PULVER
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 BLANKENSHIP RD
Mailing Address - Street 2:SUITE 448
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4172
Mailing Address - Country:US
Mailing Address - Phone:503-929-7722
Mailing Address - Fax:503-451-6822
Practice Address - Street 1:1800 BLANKENSHIP RD
Practice Address - Street 2:SUITE 448
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4172
Practice Address - Country:US
Practice Address - Phone:503-929-7722
Practice Address - Fax:503-451-6822
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200341425RN163W00000X
OR201050014NP363LF0000X, 363L00000X
WARN00176010163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner