Provider Demographics
NPI:1457502163
Name:VORASS, MELANY RAE (LMP)
Entity Type:Individual
Prefix:MS
First Name:MELANY
Middle Name:RAE
Last Name:VORASS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2312 N 59TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-5731
Mailing Address - Country:US
Mailing Address - Phone:206-491-4565
Mailing Address - Fax:
Practice Address - Street 1:2312 N 59TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5731
Practice Address - Country:US
Practice Address - Phone:206-491-4565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024948225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA00024948OtherSTATE OF WASHINGTON DEPARTMENT OF LICENSING