Provider Demographics
NPI:1407040074
Name:VONRANKER, MARY VEE (LMP, CR)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:VEE
Last Name:VONRANKER
Suffix:
Gender:F
Credentials:LMP, CR
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:USCHOLD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMP, CR
Mailing Address - Street 1:PO BOX 40089
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98015-4089
Mailing Address - Country:US
Mailing Address - Phone:425-591-3779
Mailing Address - Fax:425-228-8288
Practice Address - Street 1:2300 130TH AVE NE
Practice Address - Street 2:BLDG A, SUITE 103
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1755
Practice Address - Country:US
Practice Address - Phone:425-591-3779
Practice Address - Fax:425-228-8288
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013123225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist