MEDICARE: RENAE L HANDLEY LMT

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	10409	HI

General Provider Information

NPI Number	:	1821226010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENAE L HANDLEY LMT

Provider Business Mailing Address
First Line	:	3904 W DAWN AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-4985
Country	:	US
Telephone Number	:	509-934-0508
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 E HASTINGS RD
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-4901
Country	:	US
Telephone Number	:	509-340-3303
Fax Number	:

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

Provider Enumeration Date	:	06/25/2009
Last Update Date	:	03/09/2018

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