Provider Demographics
NPI:1376893990
Name:JUSTICE, RANA (MOTR/L)
Entity Type:Individual
Prefix:
First Name:RANA
Middle Name:
Last Name:JUSTICE
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 GRANITE LN
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-8778
Mailing Address - Country:US
Mailing Address - Phone:307-262-6692
Mailing Address - Fax:
Practice Address - Street 1:102 GRANITE LN
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-8778
Practice Address - Country:US
Practice Address - Phone:307-262-6692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist