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General NPI Number Information
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NPI Number | 1891258976
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Entity Type | Individual
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Provider Name | CHELSEA RAYE LMT
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Gender | Female
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Dates
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Enumeration Date | 04/07/2019
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Last Update Date | 04/07/2019
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Provider Practice Location Address
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Address Line | 17030 SE 1ST ST STE 102
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City | VANCOUVER
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State | WA
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Zip | 98684-8514
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Country | US
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Telephone | 360-604-1226
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Fax |
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Provider Business Mailing Address
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Address Line | 15510 NE 82ND CIR
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City | VANCOUVER
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State | WA
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Zip | 98682-3745
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Country | US
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Telephone | 808-652-5126
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 60679024
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License Number State | WA
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