Provider Demographics
NPI:1285868455
Name:LE, RACHEL LEE (LMT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEE
Last Name:LE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LEE
Other - Last Name:CRISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:634 E 73RD AVE
Mailing Address - Street 2:C
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-2814
Mailing Address - Country:US
Mailing Address - Phone:907-743-0322
Mailing Address - Fax:
Practice Address - Street 1:634 E 73RD AVE
Practice Address - Street 2:C
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-2814
Practice Address - Country:US
Practice Address - Phone:907-743-0322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKMP1508225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist