Provider Demographics
NPI:1417093311
Name:SCOTT, RACHAEL E
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:E
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 ALDERWOOD MALL PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6920
Mailing Address - Country:US
Mailing Address - Phone:206-406-1659
Mailing Address - Fax:425-771-2425
Practice Address - Street 1:3005 ALDERWOOD MALL PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6920
Practice Address - Country:US
Practice Address - Phone:206-406-1659
Practice Address - Fax:425-771-2425
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00020214225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist