MEDICARE: ANN ROSS LMP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MA00020045	WA

General Provider Information

NPI Number	:	1376764068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN ROSS LMP

Provider Business Mailing Address
First Line	:	337 NE THORNTON PL
Second Line	:	APT 244
City	:	SEATTLE
State	:	WA
Zip	:	98125-8036
Country	:	US
Telephone Number	:	425-501-8712
Fax Number	:

Provider Business Practice Location Address
First Line	:	8115 STONE AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4414
Country	:	US
Telephone Number	:	425-501-8712
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	10/29/2010

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Directions to “ ANN ROSS LMP” Practice Location

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