Individual
RENEE YVETTE GLANVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.P.
Contact information
Practice address
6515 12TH AVE NE, SEATTLE, WA 98115-6753
(206) 335-4974
(425) 361-1730
Mailing address
117 E LOUISA ST, PMB 273, SEATTLE, WA 98102-3203
(206) 335-4974
(425) 361-1730
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00007117
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208207224735
PREMERA BLUE CROSS
WA
01
—
50290
LABOR AND INDUSTRY
WA
Enumeration date
12/19/2006
Last updated
07/08/2007
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