MEDICARE: MS. MELANY RAE VORASS 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	MA00024948	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MA00024948	OTHER	WA	STATE OF WASHINGTON DEPARTMENT OF LICENSING

General Provider Information

NPI Number	:	1457502163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELANY RAE VORASS LMP

Provider Business Mailing Address
First Line	:	2312 N 59TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-5731
Country	:	US
Telephone Number	:	206-491-4565
Fax Number	:

Provider Business Practice Location Address
First Line	:	2312 N 59TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-5731
Country	:	US
Telephone Number	:	206-491-4565
Fax Number	:

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

Provider Enumeration Date	:	10/01/2008
Last Update Date	:	10/01/2008

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