Provider Demographics
NPI:1235995101
Name:RAI, SOLARIS (LMT)
Entity Type:Individual
Prefix:
First Name:SOLARIS
Middle Name:
Last Name:RAI
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 1:6266 GREENBOWER LN UNIT B
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:WA
Mailing Address - Zip Code:98236-9007
Mailing Address - Country:US
Mailing Address - Phone:850-445-2164
Mailing Address - Fax:850-445-2164
Practice Address - Street 1:2815 HOWARD RD STE J
Practice Address - Street 2:
Practice Address - City:LANGLEY
Practice Address - State:WA
Practice Address - Zip Code:98260-8530
Practice Address - Country:US
Practice Address - Phone:850-445-2164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMASS.MA.61488445225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist