Individual
THERESA RAEDEL RUNDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
228 W MAIN ST, MSCH-14, GOLDENDALE, WA 98620-9597
(509) 493-1558
(509) 493-4025
Mailing address
92 RUNDELL RD, P.O. BOX 268, UNDERWOOD, WA 98651-9110
(509) 637-0702
(509) 493-4025
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
AP30001463
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8602492
—
WA
Enumeration date
12/04/2006
Last updated
07/09/2007
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