Provider Demographics
NPI:1427729334
Name:GARDNER, RHONDA LEE (RN)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:LEE
Last Name:GARDNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3008 N NARROWS DR UNIT B302
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-1576
Mailing Address - Country:US
Mailing Address - Phone:253-224-6914
Mailing Address - Fax:
Practice Address - Street 1:4700 POINT FOSDICK DR STE 307
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1706
Practice Address - Country:US
Practice Address - Phone:253-272-8664
Practice Address - Fax:253-857-2956
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00131246163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARN00131246OtherWASHINGTON DEPARTMENT OF LICENSE