Provider Demographics
NPI:1063176089
Name:RITOLA, MICHELLE MARIE (ND)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MARIE
Last Name:RITOLA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1339 COMMERCE AVE STE 310C
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-3728
Mailing Address - Country:US
Mailing Address - Phone:360-270-8500
Mailing Address - Fax:360-442-4572
Practice Address - Street 1:1339 COMMERCE AVE STE 310C
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3728
Practice Address - Country:US
Practice Address - Phone:360-270-8500
Practice Address - Fax:360-442-4572
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4430175F00000X
WANT61213895175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath