Provider Demographics
NPI:1881825313
Name:RAYE, MELISSA ANN (BA, LMP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:RAYE
Suffix:
Gender:F
Credentials:BA, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 CORLISS AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-9116
Mailing Address - Country:US
Mailing Address - Phone:206-755-6965
Mailing Address - Fax:
Practice Address - Street 1:14535 BEL RED RD
Practice Address - Street 2:SUITE #202
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3907
Practice Address - Country:US
Practice Address - Phone:206-755-6965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00012118225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist