Provider Demographics
NPI:1326315987
Name:RAU, LUCINDA J (ARNP)
Entity Type:Individual
Prefix:
First Name:LUCINDA
Middle Name:J
Last Name:RAU
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 FORT ST
Mailing Address - Street 2:PO BOX 410
Mailing Address - City:NEAH BAY
Mailing Address - State:WA
Mailing Address - Zip Code:98357-0410
Mailing Address - Country:US
Mailing Address - Phone:360-645-2628
Mailing Address - Fax:
Practice Address - Street 1:250 FORT ST
Practice Address - Street 2:
Practice Address - City:NEAH BAY
Practice Address - State:WA
Practice Address - Zip Code:98357-4003
Practice Address - Country:US
Practice Address - Phone:360-645-2233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9228085363LF0000X
WAAP60686615363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGX404ZMedicare PIN