Individual
NATHANIAL ODELL RENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
21907 64TH AVE W STE 200, MOUNTLAKE TERRACE, WA 98043-6200
(425) 640-7009
Mailing address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60284806
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
01/23/2013
Last updated
10/14/2022
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