Provider Demographics
NPI:1104602929
Name:RANZ, MICHEALA
Entity type:Individual
Prefix:
First Name:MICHEALA
Middle Name:
Last Name:RANZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31603 W RUTHERFORD ST
Mailing Address - Street 2:
Mailing Address - City:CARNATION
Mailing Address - State:WA
Mailing Address - Zip Code:98014-7632
Mailing Address - Country:US
Mailing Address - Phone:206-218-5678
Mailing Address - Fax:
Practice Address - Street 1:31603 W RUTHERFORD ST
Practice Address - Street 2:
Practice Address - City:CARNATION
Practice Address - State:WA
Practice Address - Zip Code:98014-7632
Practice Address - Country:US
Practice Address - Phone:206-218-5678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist