Provider Demographics
NPI:1598118051
Name:JAMES, RAESHAY
Entity Type:Individual
Prefix:
First Name:RAESHAY
Middle Name:
Last Name:JAMES
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 1:100 PARKWEST DR
Mailing Address - Street 2:APT# 2G7
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-2597
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 PARKWEST DR APT 2G7
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-2593
Practice Address - Country:US
Practice Address - Phone:517-993-4950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other