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Individual

BRENDA SLAGLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
174 1ST AVE N, ILWACO, WA 98624-9137
(360) 642-6308
Mailing address
174 1ST AVE N, ILWACO, WA 98624-9137
(360) 642-6308

Taxonomy

Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
RN60131693
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN60131693
RN LICENSURE
WA
Enumeration date
08/22/2018
Last updated
08/22/2018
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