Provider Demographics
NPI:1841503661
Name:PHILLIPS, RILEE MICHELE (LMT)
Entity type:Individual
Prefix:MISS
First Name:RILEE
Middle Name:MICHELE
Last Name:PHILLIPS
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 1:24909 104TH AVE SE STE 103
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-2819
Mailing Address - Country:US
Mailing Address - Phone:253-850-8163
Mailing Address - Fax:
Practice Address - Street 1:24909 104TH AVE SE STE 103
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-2819
Practice Address - Country:US
Practice Address - Phone:253-850-8163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60077020225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist