MEDICARE: RACHEL SARANNE YANTZER LMP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA00015975	WA

General Provider Information

NPI Number	:	1255479812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL SARANNE YANTZER LMP

Provider Business Mailing Address
First Line	:	58 SW BACHELOR FLAT LN
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98367-9647
Country	:	US
Telephone Number	:	253-225-7199
Fax Number	:

Provider Business Practice Location Address
First Line	:	11515 BURNHAM DR
Second Line	:
City	:	GIG HARBOR
State	:	WA
Zip	:	98332-8543
Country	:	US
Telephone Number	:	253-858-5152
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	03/16/2021

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