Individual
TARA ASCHENBRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4012 WIGGINS RD SE, OLYMPIA, WA 98501-4372
(360) 491-1036
Mailing address
304 LONGMIRE STREET, APT A103, YELM, WA 98597
(360) 701-6063
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60649499
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164W00000X
—
WA
Enumeration date
07/26/2016
Last updated
07/26/2016
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