Provider Demographics
NPI:1922030170
Name:RANTOS, PATRICIA R (NP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:R
Last Name:RANTOS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:R
Other - Last Name:RANTOS-MAGNUSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:820 N CHELAN AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2028
Mailing Address - Country:US
Mailing Address - Phone:509-663-8711
Mailing Address - Fax:
Practice Address - Street 1:820 N CHELAN AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2028
Practice Address - Country:US
Practice Address - Phone:509-663-8711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004047363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA500027712OtherRAILROAD MC # VM
WA1922030170Medicaid
WAG8874144OtherMEDICARE NUMBER FOR LYNNWOOD LOCATION
WA6374RAOtherBLUE SHIELD # VM
WA6374RAOtherBLUE SHIELD # VM
WA500027712OtherRAILROAD MC # VM
WAG8874144OtherMEDICARE NUMBER FOR LYNNWOOD LOCATION
WAAB33500Medicare PIN