Provider Demographics
NPI:1194146084
Name:RAMIREZ, JEANENNE (LMP)
Entity type:Individual
Prefix:
First Name:JEANENNE
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:JEANENNE
Other - Middle Name:
Other - Last Name:BERCIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13701 E SPRAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-0811
Mailing Address - Country:US
Mailing Address - Phone:509-922-5585
Mailing Address - Fax:509-927-7336
Practice Address - Street 1:13701 E SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-0811
Practice Address - Country:US
Practice Address - Phone:509-922-5585
Practice Address - Fax:509-927-7336
Is Sole Proprietor?:No
Enumeration Date:2013-12-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60392598225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist