Provider Demographics
NPI:1962711192
Name:GRIPMAN, MONICA TOMI (MONICA GRIPMAN)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:TOMI
Last Name:GRIPMAN
Suffix:
Gender:F
Credentials:MONICA GRIPMAN
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:TOMI
Other - Last Name:GRIPMAN
Other - Suffix:I
Other - Last Name Type:Other Name
Other - Credentials:MONICA GRIPMAN
Mailing Address - Street 1:PO BOX 1001
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-1001
Mailing Address - Country:US
Mailing Address - Phone:206-234-8102
Mailing Address - Fax:
Practice Address - Street 1:16841 COVE WALK SW
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-4422
Practice Address - Country:US
Practice Address - Phone:206-234-8102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist