Provider Demographics
NPI:1497189021
Name:PIERCE, RENEE D (BA)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:D
Last Name:PIERCE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:
Practice Address - Street 1:9706 4TH AVE NE
Practice Address - Street 2:#303
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2157
Practice Address - Country:US
Practice Address - Phone:206-302-2910
Practice Address - Fax:206-302-2910
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WA171M00000X171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No171M00000XOther Service ProvidersCase Manager/Care Coordinator