Provider Demographics
NPI:1457755076
Name:RIPPEE, LORETTA (EDM, LMHC)
Entity Type:Individual
Prefix:
First Name:LORETTA
Middle Name:
Last Name:RIPPEE
Suffix:
Gender:F
Credentials:EDM, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1007
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-0130
Mailing Address - Country:US
Mailing Address - Phone:360-508-9210
Mailing Address - Fax:
Practice Address - Street 1:1021 S MARKET BLVD
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-3425
Practice Address - Country:US
Practice Address - Phone:360-508-9210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH6013586676101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor