Healthcare Provider Details

I. General information

NPI: 1033500715
Provider Name (Legal Business Name): MARIAN KRANZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2015
Last Update Date: 02/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3919 S 19TH ST
TACOMA WA
98405-1414
US

IV. Provider business mailing address

19264 208TH AVE SE
RENTON WA
98058-0206
US

V. Phone/Fax

Practice location:
  • Phone: 253-752-5677
  • Fax: 253-759-3621
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT 00005313
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: