Provider Demographics
NPI:1710389002
Name:RAYMER, CHRYSTAL ERIN (LMP)
Entity Type:Individual
Prefix:MRS
First Name:CHRYSTAL
Middle Name:ERIN
Last Name:RAYMER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15817 40TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-7738
Mailing Address - Country:US
Mailing Address - Phone:425-231-9597
Mailing Address - Fax:
Practice Address - Street 1:15817 40TH AVE NW
Practice Address - Street 2:
Practice Address - City:STANWOOD
Practice Address - State:WA
Practice Address - Zip Code:98292-7738
Practice Address - Country:US
Practice Address - Phone:425-231-9597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024892225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist