Provider Demographics
NPI:1093434698
Name:SCHAFFER, RHIANNON
Entity Type:Individual
Prefix:
First Name:RHIANNON
Middle Name:
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 STATE AVE NE # 573
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1131
Mailing Address - Country:US
Mailing Address - Phone:208-901-2232
Mailing Address - Fax:
Practice Address - Street 1:514 YELM AVE W
Practice Address - Street 2:
Practice Address - City:YELM
Practice Address - State:WA
Practice Address - Zip Code:98597-7679
Practice Address - Country:US
Practice Address - Phone:360-458-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225700000X
225700000X
WA61308021225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist