Individual
RENUKA DEONARINESINGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-1110
Mailing address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(863) 386-4711
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9105305
FL
363AS0400X
Surgical Physician Assistant
PA9105305
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002664400
—
FL
Enumeration date
02/18/2010
Last updated
08/15/2022
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