Provider Demographics
NPI:1972101160
Name:RANA, ANKITA (DPT, MPT (M), BPT)
Entity type:Individual
Prefix:
First Name:ANKITA
Middle Name:
Last Name:RANA
Suffix:
Gender:F
Credentials:DPT, MPT (M), BPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17202 AURORA AVE N APT 513
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-5359
Mailing Address - Country:US
Mailing Address - Phone:224-703-4331
Mailing Address - Fax:
Practice Address - Street 1:19221 36TH AVE W STE 101
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5700
Practice Address - Country:US
Practice Address - Phone:425-774-9564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-11
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501018608225100000X
WAPT61021267225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist