Individual
MRS. TERESA LOANN RENNELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1292 SE HOLGATE BLVD, PORTLAND, OR 97202-5053
(503) 395-7736
Mailing address
15511 NE 102ND ST, VANCOUVER, WA 98682-1941
(360) 977-0445
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201906658RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201906658RN
STATE NURSING BOARD
OR
01
—
RN60538564
STATE NURSING BOARD
WA
Enumeration date
08/21/2023
Last updated
08/21/2023
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