Healthcare Provider Details

I. General information

NPI: 1841154143
Provider Name (Legal Business Name): LONI RAE STORRS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 MARTIN WAY E STE 117
OLYMPIA WA
98516-5586
US

IV. Provider business mailing address

5320 S WAPATO ST
TACOMA WA
98409-7040
US

V. Phone/Fax

Practice location:
  • Phone: 360-413-6910
  • Fax:
Mailing address:
  • Phone: 360-413-6910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: