Provider Demographics
NPI:1295006534
Name:MEDLEY, RACHEL E (LMT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:E
Last Name:MEDLEY
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 1:1405 FRASER ST # 1
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-5886
Mailing Address - Country:US
Mailing Address - Phone:541-863-9364
Mailing Address - Fax:360-483-5158
Practice Address - Street 1:1301 FRASER ST STE A-109
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-5851
Practice Address - Country:US
Practice Address - Phone:541-863-9364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60647586225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist