Provider Demographics
NPI:1144992314
Name:RAPP, TANNER (RN)
Entity type:Individual
Prefix:
First Name:TANNER
Middle Name:
Last Name:RAPP
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W A ST
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-2605
Mailing Address - Country:US
Mailing Address - Phone:509-961-6336
Mailing Address - Fax:509-452-1004
Practice Address - Street 1:611 W A ST
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-2605
Practice Address - Country:US
Practice Address - Phone:509-961-6336
Practice Address - Fax:509-452-1004
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP61469690101YA0400X
WARN60912791163WC1500X
WAAP61273001363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily