Provider Demographics
NPI:1255479812
Name:YANTZER, RACHEL SARANNE (LMP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:SARANNE
Last Name:YANTZER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 SW BACHELOR FLAT LN
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-9647
Mailing Address - Country:US
Mailing Address - Phone:253-225-7199
Mailing Address - Fax:
Practice Address - Street 1:11515 BURNHAM DR
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8543
Practice Address - Country:US
Practice Address - Phone:253-858-5152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015975225700000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist