Most Relevant Information
Provider Data
| NPI Number: | 1003499039 |
| Provider Name: | CODY RASMUSSEN |
| Entity Type: | Individual |
| Taxonomy Code: | 3747A0650X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/28/2021 |
| Last Updated: | 04/28/2021 |
Provider Practice Location
636 CALIFORNIA WAY
LONGVIEW
WA
986321651
Practice Location Phone/Fax
| Phone: | 5414974079 |
| Fax: |
Provider Mailing Location
636 CALIFORNIA WAY
LONGVIEW
WA
986321651
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |