Provider Demographics
NPI:1902907538
Name:RENTSCHLER, VANESSA CHRISTINE (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:CHRISTINE
Last Name:RENTSCHLER
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:847 NE 19TH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2684
Mailing Address - Country:US
Mailing Address - Phone:503-963-2801
Mailing Address - Fax:503-963-2825
Practice Address - Street 1:2222 NW LOVEJOY ST
Practice Address - Street 2:SUITE 622
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3033
Practice Address - Country:US
Practice Address - Phone:503-229-8455
Practice Address - Fax:503-229-7028
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24099231H00000X
CAAU 2715231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR004127Medicaid
OR500679669Medicaid
OR187681Medicare PIN