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NPI Code Detail

MEDICARE: KRISTEN RAYNER LMP

MEDICARE:   KRISTEN  RAYNER  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
1225700000XMassage TherapistMA 60088318WA

General Provider Information

NPI Number : 1417251620
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN RAYNER LMP
Provider Business Mailing Address
First Line : 401 OLYMPIA AVE NE BOX 12
Second Line : SUITE 238
City : RENTON
State : WA
Zip : 98056-4119
Country : US
Telephone Number : 425-988-4000
Fax Number :
Provider Business Practice Location Address
First Line : 401 OLYMPIA AVE NE BOX 12
Second Line : SUITE 238
City : RENTON
State : WA
Zip : 98056-4119
Country : US
Telephone Number : 425-988-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2011
Last Update Date : 01/03/2011

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Directions to “ KRISTEN RAYNER LMP” Practice Location

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