Provider Demographics
NPI:1013082510
Name:RASEY, JAMES WILLIAM (LMT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAM
Last Name:RASEY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9202 S WILGUS RD
Mailing Address - Street 2:
Mailing Address - City:PROSSER
Mailing Address - State:WA
Mailing Address - Zip Code:99350-7228
Mailing Address - Country:US
Mailing Address - Phone:509-832-1716
Mailing Address - Fax:509-786-7694
Practice Address - Street 1:705 7TH ST
Practice Address - Street 2:
Practice Address - City:PROSSER
Practice Address - State:WA
Practice Address - Zip Code:99350-1457
Practice Address - Country:US
Practice Address - Phone:509-832-1716
Practice Address - Fax:509-786-7694
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012654174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist