Provider Demographics
NPI:1609081165
Name:RHOADS, NAOMI R (LAC, LMP)
Entity Type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:R
Last Name:RHOADS
Suffix:
Gender:F
Credentials:LAC, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10930 SE 256TH ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-9308
Mailing Address - Country:US
Mailing Address - Phone:253-277-0927
Mailing Address - Fax:
Practice Address - Street 1:10930 SE 256TH ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-9308
Practice Address - Country:US
Practice Address - Phone:253-277-0927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000146171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist