Provider Demographics
NPI:1487029864
Name:NORRIS, RACHEL HAWLEY (CMT)
Entity Type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:HAWLEY
Last Name:NORRIS
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 ARMORY DR.
Mailing Address - Street 2:B
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401
Mailing Address - Country:US
Mailing Address - Phone:707-771-0785
Mailing Address - Fax:
Practice Address - Street 1:1333 W STEELE LN
Practice Address - Street 2:APT.445
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-2991
Practice Address - Country:US
Practice Address - Phone:707-771-0785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19928225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist