Aidan H Derenne
Adolescent Medicine
505 Ne 87th Ave Ste 120
Vancouver
, Washington 98664-1989
Aidan H Derenne
Adolescent Medicine
505 Ne 87th Ave Ste 120
Vancouver
, Washington 98664-1989
(360) 892-3146
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Aidan H Derenne
- 505 Ne 87th Ave Ste 120
- Vancouver, WA
- Zip : 98664-1989
- Fax : (360) 892-3146
- Phone : (360) 892-1635
Second Address
- Aidan H Derenne
- 505 Ne 87th Ave Ste 120
- Vancouver, WA
- Zip : 98664-1989
- Fax : (360) 892-3146
- Phone : (360) 892-1635
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Is Aidan H Derenne a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | MD00037036 | WA |
National Provider Identifier
| NPI | 1003886805 |
|---|---|
| Provider Name | Aidan H Derenne |
| First Address | Vancouver, WA 98664-1989 |
| Second Address | Vancouver, WA 98664-1989 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/01/2006 |
| Last Update Date | 10/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1106434 | (05) | WA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.