Provider Demographics
NPI:1710744297
Name:RAE'S NATURAL THERAPY
Entity Type:Organization
Organization Name:RAE'S NATURAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ENOCKSEN
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:425-220-9649
Mailing Address - Street 1:8021 224TH ST SE
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-9775
Mailing Address - Country:US
Mailing Address - Phone:425-220-9649
Mailing Address - Fax:
Practice Address - Street 1:8021 224TH ST SE
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-9775
Practice Address - Country:US
Practice Address - Phone:425-220-9649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty