Provider Demographics
NPI:1740404565
Name:RENN-LASHER, RODIE ADELINE (MS, ARNP, APN-C)
Entity type:Individual
Prefix:
First Name:RODIE
Middle Name:ADELINE
Last Name:RENN-LASHER
Suffix:
Gender:F
Credentials:MS, ARNP, APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 864
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98666-0864
Mailing Address - Country:US
Mailing Address - Phone:360-608-5839
Mailing Address - Fax:
Practice Address - Street 1:221 NE 104TH AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-4505
Practice Address - Country:US
Practice Address - Phone:360-253-2525
Practice Address - Fax:360-253-3611
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001630363LA2200X
OR200950042NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0184797OtherLABOR & INDUSTRIES