Provider Demographics
NPI:1114163615
Name:KANE-RONNING, INC.
Entity Type:Organization
Organization Name:KANE-RONNING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:KANE-RONNING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:360-714-8109
Mailing Address - Street 1:1117 ELLIS ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5203
Mailing Address - Country:US
Mailing Address - Phone:360-714-8109
Mailing Address - Fax:360-756-8936
Practice Address - Street 1:1117 ELLIS ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5203
Practice Address - Country:US
Practice Address - Phone:360-714-8109
Practice Address - Fax:360-756-8936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001969103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty