MATTHEW STEVEN RENNER (NPI# 1740611557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740611557 |
| Entity Type | Individual |
| Full Name | MATTHEW STEVEN RENNER |
| Credential | PA-C |
| Practice Address |
615 Lilly Rd Ne Ste 220 Olympia WA 98506-5137 |
| Mailing Address |
Po Box 3360 Portland OR 97208-3360 |
| Practice Telephone | 3604866150 |
| Practice Fax Number | 3604866155 |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2017-12-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA60755013 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174787097 | Matthew D Renner | Obstetrics & Gynecology | 100 E Idaho St, Suite 400, Boise, ID 83712-6267 | 2008-07-10 |
| 1457510604 | Matthew Edward Renner | Physical Therapist | 6744 Clayton Rd, Suite 220, Saint Louis, MO 63117-1637 | 2008-06-03 |
| 1942229190 | Matthew C Renner | Optometrist | 6801 Rogers Ave, Fort Smith, AR 72903-4067 | 2006-07-19 |
| Street Address |
615 LILLY RD NE STE 220 |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506-5137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548201346 | Brian A Iuliano | Neurological Surgery | 615 Lilly Rd Ne Ste 220, Pmg Sw Wa Neurosurgery, Olympia, WA 98506-5137 | 2006-06-10 |
| 1588218929 | Anamaria Schier | Physician Assistant | 615 Lilly Rd Ne Ste 220, Olympia, WA 98506-5137 | 2019-07-24 |
| 1083952527 | Amy Marie Diaz | Nurse Practitioner | 615 Lilly Rd Ne Ste 220, Pmg Sw Wa Neurosurgery, Olympia, WA 98506-5137 | 2013-01-17 |
| 1700131349 | Joan Danell Scott | Physician Assistant | 615 Lilly Rd Ne Ste 220, Olympia, WA 98506-5137 | 2012-07-19 |
| 1649389263 | Barbara Eileen Lazio | Neurological Surgery | 615 Lilly Rd Ne Ste 220, Olympia, WA 98506-5137 | 2006-08-29 |
| 1144250572 | Gregory B Raappana | Physician Assistant | 615 Lilly Rd Ne Ste 220, Pmg Sw Wa Neurosurgery, Olympia, WA 98506-5137 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
| 1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
| 1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
| 1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
| 1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
| 1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
| Find all providers in zip 98506 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295778165 | Christopher S Johnson | Physician Assistant | 3920 Capitol Mall Drive Sw, Suite 201, Olympia, WA 98502-8700 | 2006-06-14 |
| 1851574750 | Providence Health & Services Washington | Physician Assistant | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2007-12-13 |
| 1124144431 | Elijah Telfare | Physician Assistant | 500 Lilly Rd Ne, Suite 100, Olympia, WA 98506-5195 | 2007-03-21 |
| 1578632238 | Joshua B Mayes | Physician Assistant | 3901 Capital Mall Dr Sw, Suite A, Olympia, WA 98502-8654 | 2006-11-07 |
| 1972536779 | Lori Anne Cardwell | Physician Assistant | 615 Lilly Rd Ne, Suite 100, Olympia, WA 98506-5117 | 2006-07-08 |
| 1124056437 | Charles W Anderegg | Physician Assistant | 3901 Capital Mall Dr Sw, Ste A, Olympia, WA 98502-8654 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780153536 | Patricia Dorian | Physician Assistant | 2950 Squalicum Pkwy Ste B, Bellingham, WA 98225-1857 | 2018-11-21 |
| 1851875561 | Sarah Gene Soloff | Physician Assistant | 9730 3rd Ave Ne Ste 201, Seattle, WA 98115-2023 | 2018-09-18 |
| 1104308394 | Johnny Thanh Nguyen | Physician Assistant | 1135 116th Ave Ne Ste 605, Bellevue, WA 98004-4697 | 2018-09-04 |
| 1558843201 | Stefanie Eller | Physician Assistant | 532 Cedar Wood Ln, Wenatchee, WA 98801-2476 | 2018-08-29 |
| 1861987992 | Lillian Baldwin Bourret | Physician Assistant | 6317 Linden Ave N, Seattle, WA 98103-5658 | 2018-07-01 |
| 1417446758 | Janelle Elizabeth Becker | Physician Assistant | 11511 Canterwood Blvd Nw Ste 205, Gig Harbor, WA 98332 | 2018-05-02 |
| 1982058418 | Ray Johnson | Physician Assistant | 4446 88th Ave Se, Mercer Island, WA 98040 | 2016-04-21 |
| 1073990651 | Laura Skanse | Physician Assistant | 12303 Ne 130th Ln #500, Kirkland, WA 98034 | 2015-05-02 |
| 1104231893 | Amber Elaine Deck | Physician Assistant | 20307 67th Ave E, Spanaway, WA 98387-5600 | 2014-06-22 |
| 1043535024 | Pamela Baird | Physician Assistant | 2016 16th Ave East, Seattle, WA 98112-5260 | 2010-04-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.