Provider Demographics
NPI:1568627503
Name:RICE, AMBER NICOLE (LMT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:RICE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6906 PETTICOTE LN
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:WA
Mailing Address - Zip Code:98230-9634
Mailing Address - Country:US
Mailing Address - Phone:509-433-4401
Mailing Address - Fax:
Practice Address - Street 1:6906 PETTICOTE LN
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:WA
Practice Address - Zip Code:98230-9634
Practice Address - Country:US
Practice Address - Phone:509-433-4401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015775225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist