Provider Demographics
NPI:1922159532
Name:RANKIN, ANNETTE R (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:R
Last Name:RANKIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15330 SE OGDEN DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-7859
Mailing Address - Country:US
Mailing Address - Phone:415-298-2479
Mailing Address - Fax:
Practice Address - Street 1:818 NW 17TH AVE STE 9
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2327
Practice Address - Country:US
Practice Address - Phone:415-298-2479
Practice Address - Fax:503-296-5492
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT1289106H00000X
CALMFT19714106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist