Provider Demographics
NPI:1023303039
Name:GRANTHAM, RHONDA LEE (CPM)
Entity type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:LEE
Last Name:GRANTHAM
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 4TH AVE E
Mailing Address - Street 2:PMB # 51
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-4632
Mailing Address - Country:US
Mailing Address - Phone:360-742-4764
Mailing Address - Fax:
Practice Address - Street 1:1313 MARION ST NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-4436
Practice Address - Country:US
Practice Address - Phone:360-742-4764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife