Provider Demographics
NPI:1124526454
Name:RAMYNKE, JESSICA RENEE (LPN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RENEE
Last Name:RAMYNKE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8310 DUFFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MOXEE
Mailing Address - State:WA
Mailing Address - Zip Code:98936-9539
Mailing Address - Country:US
Mailing Address - Phone:509-834-1485
Mailing Address - Fax:
Practice Address - Street 1:2000 S 18TH ST
Practice Address - Street 2:
Practice Address - City:UNION GAP
Practice Address - State:WA
Practice Address - Zip Code:98903-3932
Practice Address - Country:US
Practice Address - Phone:509-573-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60608218164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse