Provider Demographics
NPI:1841591633
Name:RANARD, CORRINE LYNAI (LMT)
Entity Type:Individual
Prefix:MS
First Name:CORRINE
Middle Name:LYNAI
Last Name:RANARD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 NE GOING ST
Mailing Address - Street 2:APT B
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-4537
Mailing Address - Country:US
Mailing Address - Phone:503-705-1088
Mailing Address - Fax:
Practice Address - Street 1:13765 NW CORNELL RD
Practice Address - Street 2:SUITE 150
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-5300
Practice Address - Country:US
Practice Address - Phone:503-705-1088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4758225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist