Provider Demographics
NPI:1164203824
Name:ECHEVERRIA, RHIANNON (LMT)
Entity type:Individual
Prefix:
First Name:RHIANNON
Middle Name:
Last Name:ECHEVERRIA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:RHIANNON
Other - Middle Name:
Other - Last Name:ROLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:1625 BLACKHAWK WAY UNIT B
Mailing Address - Street 2:
Mailing Address - City:JBER
Mailing Address - State:AK
Mailing Address - Zip Code:99505-1340
Mailing Address - Country:US
Mailing Address - Phone:907-947-8554
Mailing Address - Fax:
Practice Address - Street 1:2121 ABBOTT RD STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-4450
Practice Address - Country:US
Practice Address - Phone:907-522-7090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK213062225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist