Provider Demographics
NPI:1619308145
Name:MOSER, RACHEL ROSE (MASSAGE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ROSE
Last Name:MOSER
Suffix:
Gender:F
Credentials:MASSAGE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18920 BOTHELL WAY NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-1981
Mailing Address - Country:US
Mailing Address - Phone:425-486-1122
Mailing Address - Fax:
Practice Address - Street 1:14090 FRYLANDS BLVD
Practice Address - Street 2:SUITE 274
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98727
Practice Address - Country:US
Practice Address - Phone:360-805-0112
Practice Address - Fax:425-487-6818
Is Sole Proprietor?:No
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00019527225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist