Provider Demographics
NPI:1164720025
Name:MITZEL, RACHEL LYNNE (CRNA, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LYNNE
Last Name:MITZEL
Suffix:
Gender:F
Credentials:CRNA, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-2106
Mailing Address - Country:US
Mailing Address - Phone:541-548-8131
Mailing Address - Fax:
Practice Address - Street 1:145 SW 6TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2106
Practice Address - Country:US
Practice Address - Phone:541-548-8131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10040206363LP0808X
WAAP60201665367500000X
OR202208498CRNA-PP367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health