Provider Demographics
NPI:1093129454
Name:RACUS, BRITNI ELAINE (MS, ATC, CSCS, PES)
Entity Type:Individual
Prefix:
First Name:BRITNI
Middle Name:ELAINE
Last Name:RACUS
Suffix:
Gender:F
Credentials:MS, ATC, CSCS, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22450 19TH AVE S
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-7623
Mailing Address - Country:US
Mailing Address - Phone:253-740-5277
Mailing Address - Fax:
Practice Address - Street 1:22450 19TH AVE S
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-7623
Practice Address - Country:US
Practice Address - Phone:253-740-5277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1603755902255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer