Provider Demographics
NPI:1699536250
Name:RAPP, JODIE LOUISE
Entity type:Individual
Prefix:
First Name:JODIE
Middle Name:LOUISE
Last Name:RAPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10207 NE 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-5626
Mailing Address - Country:US
Mailing Address - Phone:360-521-7176
Mailing Address - Fax:
Practice Address - Street 1:9901 NE 7TH AVE STE C116
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-4528
Practice Address - Country:US
Practice Address - Phone:360-571-2432
Practice Address - Fax:360-326-9195
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician