Renco, Fred H.

Renco, Fred H. is an individual health care provider with primary practice located at 1400 E. Kincaid Street , Mount Vernon WA 98274-4127. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Renco, Fred H. can be contacted via phone (360) 428-2586.

Contact Information

Primary practice address
1400 E. Kincaid Street Mount Vernon WA 98274-4127
Phone: (360) 428-2586
Fax: (360) 428-6470
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA00003130 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA10003130 Washington

Profile Details

NPI number 1922062090
LBN Legal business name Renco, Fred H.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2006
Last updated Jun 17th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922062090 NPPES
Washington Other 263689 LABOR & INDUSTRIES
Washington MEDICAID 1022277 LABOR & INDUSTRIES
Washington MEDICAID 8200024 LABOR & INDUSTRIES

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