Healthcare Provider Details

I. General information

NPI: 1427391580
Provider Name (Legal Business Name): EDIE RAHLF LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8615 S TACOMA WAY OLYMPUS SPA
LAKEWOOD WA
98499
US

IV. Provider business mailing address

8235 S PARK AVE #556
TACOMA WA
98408-5227
US

V. Phone/Fax

Practice location:
  • Phone: 253-588-3355
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00014495
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: