Provider Demographics
NPI:1386655181
Name:RAINEY, LAWRENCE C (PHD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:C
Last Name:RAINEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 9TH AVE
Mailing Address - Street 2:MS:M4-PA
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-515-5811
Mailing Address - Fax:
Practice Address - Street 1:1100 OLIVE WAY STE 531
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1873
Practice Address - Country:US
Practice Address - Phone:206-223-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001009103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAJA1697OtherINDIVIDUAL BLUE SHIELD
WA069741075OtherGROUP HEALTH
WA0039586OtherLABOR & INDUSTRIES
WAUS0862238OtherAETNA SPECIALIST NUMBER
WAJA1697OtherINDIVIDUAL BLUE SHIELD
R11228Medicare UPIN
WA000182603Medicare PIN