Provider Demographics
NPI:1912877093
Name:BERETA, RACHAEL ELIZABETH (LMT)
Entity type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:ELIZABETH
Last Name:BERETA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:ELIZABETH
Other - Last Name:THORNEYCROFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:609 S LYSTIL LN
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-3054
Mailing Address - Country:US
Mailing Address - Phone:509-797-4813
Mailing Address - Fax:
Practice Address - Street 1:208 S DIVISION ST
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-1954
Practice Address - Country:US
Practice Address - Phone:509-797-4813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61458813225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist