Provider Demographics
NPI:1346763406
Name:RANEY, AMY ELISABETH
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELISABETH
Last Name:RANEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 NE 146TH AVE APT 328
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-4274
Mailing Address - Country:US
Mailing Address - Phone:503-522-1251
Mailing Address - Fax:
Practice Address - Street 1:333 NE 146TH AVE APT 328
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-4274
Practice Address - Country:US
Practice Address - Phone:503-522-1251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator