Provider Demographics
NPI:1376764068
Name:ROSS, ANN (LMP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 NE THORNTON PL
Mailing Address - Street 2:APT 244
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-8036
Mailing Address - Country:US
Mailing Address - Phone:425-501-8712
Mailing Address - Fax:
Practice Address - Street 1:8115 STONE AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-4414
Practice Address - Country:US
Practice Address - Phone:425-501-8712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00020045174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist