Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | AP30007277 | WA |
NPI | 1144319963 |
---|---|
Provider Name | Ms. Ramona J Granath |
First Address | Scappoose, OR 97056-9634 |
Second Address | Vancouver, WA 98664-3200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 08/07/2007 |