Provider Demographics
NPI:1285247098
Name:RAMIREZ, JAN CLARE RABANG (OCCUPATIONAL THERAPY)
Entity type:Individual
Prefix:
First Name:JAN CLARE
Middle Name:RABANG
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23812 134TH PL SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-5107
Mailing Address - Country:US
Mailing Address - Phone:206-245-5518
Mailing Address - Fax:
Practice Address - Street 1:7810 SE 30TH ST
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-6002
Practice Address - Country:US
Practice Address - Phone:206-962-5479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00004418225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist