Rae D Mullin, LMT, GCFP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

24823 Issued in OR

Practice address

333 NE Russell St
Portland, OR 97212-3762

Phone

(503) 289-1390

NPI assigned

Apr 12, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Rachel D Mullin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1265995575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 SE 65TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972152039",
            "telephone_number": "503-756-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 NE RUSSELL ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123762",
            "telephone_number": "503-289-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIN",
        "first_name": "RAE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "LMT, GCFP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "24823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "MULLIN",
            "middle_name": "D",
            "credential": "GCFP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Edward Mulligan IV, CRM
• Michael Mulligan
• Michael Trew Mulligan, LMFT
• Christina J Mullin, LCSW
• Rachael Elizabeth Mullin, DO
• Adrienne Noel Mullinax, LMT
• Jean Hannon Mullins-Padgett, AGACNP-BC
• Clint Eugene Mullins
• Joanna Marie Mullins, R.D.H. , B.S.
• Richard James Mullins, MD

• Massage Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.