Provider Demographics
NPI:1285450759
Name:VON MORITZ, ANN L (LM/CPM)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:L
Last Name:VON MORITZ
Suffix:
Gender:F
Credentials:LM/CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 N HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:WA
Mailing Address - Zip Code:98407-3115
Mailing Address - Country:US
Mailing Address - Phone:253-678-6460
Mailing Address - Fax:
Practice Address - Street 1:1415 S 7TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-3661
Practice Address - Country:US
Practice Address - Phone:253-219-6249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-29
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW61608271176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife