Provider Demographics
NPI:1548752009
Name:RAE, CYNTHIA (CHT, RBT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:RAE
Suffix:
Gender:F
Credentials:CHT, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 2ND ST STE 211
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-2997
Mailing Address - Country:US
Mailing Address - Phone:844-454-3210
Mailing Address - Fax:
Practice Address - Street 1:605 2ND ST STE 211
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2997
Practice Address - Country:US
Practice Address - Phone:844-454-3210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60646940101Y00000X, 174400000X
374K00000X
WA60780344106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner