Provider Demographics
NPI:1740550292
Name:FRIDYE, RACHEL (LMT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:FRIDYE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 N MULLAN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4043
Mailing Address - Country:US
Mailing Address - Phone:509-927-8997
Mailing Address - Fax:509-927-3919
Practice Address - Street 1:1410 N MULLAN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4043
Practice Address - Country:US
Practice Address - Phone:509-927-8997
Practice Address - Fax:509-927-3919
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60247784225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist