Provider Demographics
NPI:1346940558
Name:RENNISON, AISLINN TERCIE-JENESS (DACM)
Entity Type:Individual
Prefix:
First Name:AISLINN
Middle Name:TERCIE-JENESS
Last Name:RENNISON
Suffix:
Gender:F
Credentials:DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3057
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-0137
Mailing Address - Country:US
Mailing Address - Phone:425-835-2503
Mailing Address - Fax:425-285-5436
Practice Address - Street 1:450 NW GILMAN BLVD STE 201
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2722
Practice Address - Country:US
Practice Address - Phone:425-835-2503
Practice Address - Fax:425-285-5436
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC61392875171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist