Healthcare Provider Details

I. General information

NPI: 1679756167
Provider Name (Legal Business Name): RACHEL LYNNETTE YEAMAN LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2007
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2207 N MOLTER RD STE 250
LIBERTY LAKE WA
99019-7582
US

IV. Provider business mailing address

2207 N MOLTER RD STE 250
LIBERTY LAKE WA
99019-7582
US

V. Phone/Fax

Practice location:
  • Phone: 509-270-1423
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00024546
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: