Healthcare Provider Details

I. General information

NPI: 1891768909
Provider Name (Legal Business Name): NAOMI RHEINER MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NE 1125 WASHINGTON ST WASHINGTON STATE UNIVERSITY
PULLMAN WA
99164-0001
US

IV. Provider business mailing address

PO BOX 642302
PULLMAN WA
99164-2302
US

V. Phone/Fax

Practice location:
  • Phone: 509-335-3575
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP30003578
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: