Individual
RENEE AMELIA WALDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
560 QUICK RD, CASTLE ROCK, WA 98611-9324
(360) 274-6150
Mailing address
560 QUICK RD, CASTLE ROCK, WA 98611-9324
(360) 274-6150
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
AP30005004
WA
363L00000X
Nurse Practitioner
08201297N3
OR
363LF0000X
Family Nurse Practitioner
Primary
AP30005004
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194936
LABOR & INDUSTRIES
WA
05
—
210235
—
OR
01
—
6687WA
REGENCE BLUE SHIELD
WA
01
—
830346687-98611-A001
TRICARE
WA
01
—
8940830
CRIME VICTIMS OF WA
WA
05
—
9644634
—
WA
Enumeration date
04/13/2006
Last updated
04/19/2023
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