Provider Demographics
NPI:1700510591
Name:RANGINENI, DURGA
Entity Type:Individual
Prefix:
First Name:DURGA
Middle Name:
Last Name:RANGINENI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 71ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-6150
Mailing Address - Country:US
Mailing Address - Phone:425-409-0502
Mailing Address - Fax:253-357-5853
Practice Address - Street 1:2001 71ST AVE SE
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-6150
Practice Address - Country:US
Practice Address - Phone:425-409-0502
Practice Address - Fax:253-357-5853
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator