Provider Demographics
NPI:1275761140
Name:HAN, RACHEL Y (LMP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:Y
Last Name:HAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:YOUNG RAN
Other - Middle Name:
Other - Last Name:HAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:2527 141ST PL SW # B
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-5691
Mailing Address - Country:US
Mailing Address - Phone:425-590-7780
Mailing Address - Fax:
Practice Address - Street 1:19514 64TH AVE W STE B
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5190
Practice Address - Country:US
Practice Address - Phone:425-590-7780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60097040225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist