Provider Demographics
NPI:1912490293
Name:RALSTON, ANN LOUISE (PT, CLT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:LOUISE
Last Name:RALSTON
Suffix:
Gender:F
Credentials:PT, CLT
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:LOUISE
Other - Last Name:SCHROCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1229 MADISON ST STE 1050
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3306
Mailing Address - Country:US
Mailing Address - Phone:206-386-2035
Mailing Address - Fax:
Practice Address - Street 1:1229 MADISON ST STE 1050
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3306
Practice Address - Country:US
Practice Address - Phone:206-386-2035
Practice Address - Fax:206-386-2999
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00006849225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist