Provider Demographics
NPI:1730302415
Name:MCGRAW, RACHEL DAWN (LMP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:DAWN
Last Name:MCGRAW
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 1:13822 DOLLY VARDEN LN NW
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-9638
Mailing Address - Country:US
Mailing Address - Phone:360-830-4363
Mailing Address - Fax:360-830-4363
Practice Address - Street 1:702 LEBO BLVD STE D
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3370
Practice Address - Country:US
Practice Address - Phone:360-908-4742
Practice Address - Fax:360-830-4363
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019309225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist