Provider Demographics
NPI:1922244094
Name:RAGUCCI, JANINE A
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:A
Last Name:RAGUCCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 HARVARD AVE E
Mailing Address - Street 2:APT 102
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-4963
Mailing Address - Country:US
Mailing Address - Phone:206-861-5110
Mailing Address - Fax:
Practice Address - Street 1:2812 E MADISON ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4872
Practice Address - Country:US
Practice Address - Phone:206-861-5110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024164174400000X
NY0-1967-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist