Healthcare Provider Details

I. General information

NPI: 1659298578
Provider Name (Legal Business Name): MICHAEL RICHARD RAAB LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 S MOUNT VERNON ST STE 201
SPOKANE WA
99223-4755
US

IV. Provider business mailing address

903 E 30TH AVE
SPOKANE WA
99203-3102
US

V. Phone/Fax

Practice location:
  • Phone: 509-280-8961
  • Fax:
Mailing address:
  • Phone: 509-280-8961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA61556925
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: