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NPI 1134514284

NPI 1134514284 : ROSANNE RATKIEWICH L.M.T., C.M.T. : OAKLAND, CA

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General NPI Number Information
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    NPI Number           |    1134514284
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    Entity Type          |    Individual 
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    Provider Name        |    ROSANNE RATKIEWICH L.M.T., C.M.T.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/04/2015
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    Last Update Date     |    04/04/2015
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Provider Practice Location Address
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    Address Line         |    3833 ARDLEY AVE 
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    City                 |    OAKLAND
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    State                |    CA
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    Zip                  |    94602-1612
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    Country              |    US
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    Telephone            |    510-761-1462
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3833 ARDLEY AVE 
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    City                 |    OAKLAND
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    State                |    CA
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    Zip                  |    94602-1612
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    Country              |    US
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    Telephone            |    510-761-1462
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    1694
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    6839
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    License Number State |    OR
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