Provider Demographics
NPI:1073238762
Name:RICE, SAVANNAH SKYE (LMT)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:SKYE
Last Name:RICE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21609 54TH AVE W
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-3019
Mailing Address - Country:US
Mailing Address - Phone:619-651-0649
Mailing Address - Fax:
Practice Address - Street 1:51 W DAYTON ST STE 102
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-4111
Practice Address - Country:US
Practice Address - Phone:206-330-1773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61214841225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist