Provider Demographics
NPI:1831213750
Name:THAMERT, RACHEL ADELINE (LMP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ADELINE
Last Name:THAMERT
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 1:12800 SE 201ST ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-1622
Mailing Address - Country:US
Mailing Address - Phone:206-714-6803
Mailing Address - Fax:
Practice Address - Street 1:12800 SE 201ST ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-1622
Practice Address - Country:US
Practice Address - Phone:206-714-6803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018868225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist