MEDICARE: MRS. RANANDA LEE SOLTANI APRN, FNP-C

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	363LF0000X	Family Nurse Practitioner	89083	OK
2	363LF0000X	Family Nurse Practitioner	AP60467455	WA

General Provider Information

NPI Number	:	1427305275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RANANDA LEE SOLTANI APRN, FNP-C

Provider Business Mailing Address
First Line	:	1455 NW IRVING ST STE 600
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97209-2277
Country	:	US
Telephone Number	:	503-684-8252
Fax Number	:	503-941-3777

Provider Business Practice Location Address
First Line	:	531 BROADWAY E UNIT 10
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-5023
Country	:	US
Telephone Number	:	503-684-8252
Fax Number	:

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

Provider Enumeration Date	:	08/11/2012
Last Update Date	:	01/10/2021

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