Healthcare Provider Details

I. General information

NPI: 1275448318
Provider Name (Legal Business Name): RHONDA GARDNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 WAINWRIGHT MEMORIAL VA MEDICAL CENTER
WALLA WALLA WA
99362
US

IV. Provider business mailing address

77 WAINWRIGHT MEMORIAL VA MEDICAL CENTER
WALLA WALLA WA
99362
US

V. Phone/Fax

Practice location:
  • Phone: 509-525-5200
  • Fax:
Mailing address:
  • Phone: 509-525-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN00158211
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: