Provider Demographics
NPI:1124258496
Name:ROHDE, RONDA K
Entity type:Individual
Prefix:
First Name:RONDA
Middle Name:K
Last Name:ROHDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RONDA
Other - Middle Name:K
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3401 CASTLEVALE RD
Mailing Address - Street 2:APT C
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-7400
Mailing Address - Country:US
Mailing Address - Phone:509-688-7598
Mailing Address - Fax:
Practice Address - Street 1:3401 CASTLEVALE RD
Practice Address - Street 2:APT C
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-7400
Practice Address - Country:US
Practice Address - Phone:509-688-7598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC60112720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health