MEDICARE: PING RATHJE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	0019015414	VA
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1609647254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PING RATHJE

Provider Business Mailing Address
First Line	:	2300 WILSON BLVD STE 700
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-5435
Country	:	US
Telephone Number	:	571-215-6709
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 100041
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22210-3041
Country	:	US
Telephone Number	:	571-215-6709
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2024
Last Update Date	:	01/10/2025

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Directions to “ PING RATHJE ” Practice Location

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