Provider Demographics
NPI:1912175670
Name:MELIAN LAFINUR, RAFAEL L (LMP)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:L
Last Name:MELIAN LAFINUR
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3449 9TH AVE W
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-1410
Mailing Address - Country:US
Mailing Address - Phone:206-755-9958
Mailing Address - Fax:
Practice Address - Street 1:5429 RUSSELL AVE NW STE 300
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4010
Practice Address - Country:US
Practice Address - Phone:206-783-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00025105225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist