Individual
MS. RAYLEEN AMY GREATHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
32018 23RD AVE S, FEDERAL WAY, WA 98003-6022
(253) 839-3030
(206) 520-1799
Mailing address
127 S 500 E STE 600, SALT LAKE CITY, UT 84102-1971
(801) 587-6336
(801) 587-6459
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60271754
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0293199
L&I
WA
05
—
1952319972
—
WA
Enumeration date
08/04/2006
Last updated
11/09/2021
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