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Individual
MELISSA RACOUILLAT
Active
Individual
MELISSA RACOUILLAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT 34048
CA
225100000X
Physical Therapist
Primary
PT60383867
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679754170
—
WA
01
—
328947
WA L&I
WA
01
—
328948
WA L&I
WA
Enumeration date
11/26/2007
Last updated
09/29/2014
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