Provider Demographics
NPI:1265076954
Name:ALMANZA, ROSE
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:ALMANZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:ALMANZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MRJN ASSOCIATES
Mailing Address - Street 1:1841 GAP RD
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:WA
Mailing Address - Zip Code:98932-9487
Mailing Address - Country:US
Mailing Address - Phone:509-439-9660
Mailing Address - Fax:
Practice Address - Street 1:1841 GAP RD
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:WA
Practice Address - Zip Code:98932-9487
Practice Address - Country:US
Practice Address - Phone:509-439-9660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
WANONEMedicaid