Provider Demographics
NPI:1699247643
Name:VEGA, RIO (LMT)
Entity type:Individual
Prefix:
First Name:RIO
Middle Name:
Last Name:VEGA
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7686 HARDING PL SE
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9544
Mailing Address - Country:US
Mailing Address - Phone:425-765-4044
Mailing Address - Fax:
Practice Address - Street 1:118 DOWNING AVE N
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045-8301
Practice Address - Country:US
Practice Address - Phone:425-888-6846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist