=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295006534
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHEL E MEDLEY LMT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/18/2012
-----------------------------------------------------
Last Update Date | 02/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1711 ELLIS ST STE 103
-----------------------------------------------------
City | BELLINGHAM
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98225-4655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-863-9364
-----------------------------------------------------
Fax | 360-483-5158
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1711 ELLIS ST STE 103
-----------------------------------------------------
City | BELLINGHAM
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98225-4655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-863-9364
-----------------------------------------------------
Fax | 360-483-5158
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | 60647586
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------