Provider Demographics
NPI:1043618168
Name:MCDONALD, RICKI D'ANN (LMP)
Entity Type:Individual
Prefix:MRS
First Name:RICKI
Middle Name:D'ANN
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:RICKI
Other - Middle Name:D'ANN
Other - Last Name:GREENWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13303 E MISSION AVE APT 158
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-2791
Mailing Address - Country:US
Mailing Address - Phone:951-522-5506
Mailing Address - Fax:
Practice Address - Street 1:13303 E MISSION AVE APT 158
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-2791
Practice Address - Country:US
Practice Address - Phone:951-522-5506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-06
Last Update Date:2014-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60519279225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist