Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | OT00003323 | WA |
NPI | 1861897522 |
---|---|
Provider Name | Mrs. Renea Lynn Patterson |
First Address | Wenatchee, WA 98801-8334 |
Second Address | Wenatchee, WA 98801-2049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2014 |
Last Update Date | 23/10/2014 |