Provider Demographics
NPI:1447760038
Name:MCKINNEY, RENEE JANNELLE (ND, LMP, BCB, CKTP)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:JANNELLE
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:ND, LMP, BCB, CKTP
Other - Prefix:DR
Other - First Name:RENEE
Other - Middle Name:JANNELLE
Other - Last Name:PLUMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND, LMP, BCB, CKTP
Mailing Address - Street 1:12306 32ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-6114
Mailing Address - Country:US
Mailing Address - Phone:253-561-6171
Mailing Address - Fax:
Practice Address - Street 1:1629 QUEEN ANNE AVE N STE 104
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2833
Practice Address - Country:US
Practice Address - Phone:206-659-0690
Practice Address - Fax:833-407-1346
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-09
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60839028175F00000X
WAMA60507963225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist