Provider Demographics
NPI:1477603116
Name:RODAK, RENEE MARIE (OTRL)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:MARIE
Last Name:RODAK
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7125 FAUNTLEROY WAY SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-2008
Mailing Address - Country:US
Mailing Address - Phone:206-953-2700
Mailing Address - Fax:206-932-3909
Practice Address - Street 1:7125 FAUNTLEROY WAY SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-2008
Practice Address - Country:US
Practice Address - Phone:206-953-2700
Practice Address - Fax:206-932-3909
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist