Gordon F. Rennie, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00016734 Issued in WA

Practice address

1450 Northwest LN SE Ste a
Lacey, WA 98503-6908

Phone

(360) 491-4460

Fax

(360) 491-3090

NPI assigned

Dec 29, 2006

Last updated

Jun 24, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: grennie95299@wm.providencedirect.org

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1144386400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 NORTHWEST LN SE STE A",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985036908",
            "telephone_number": "360-491-4460",
            "fax_number": "360-491-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNIE",
        "first_name": "GORDON",
        "middle_name": "F.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00016734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "grennie95299@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1450 Northwest Ln SE Ste A",
            "city": "Lacey",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985036908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Relentless Pursuit Counseling Services
• Renae Lewandowski Otr/L, Inc. PS
• Renal Care Group Northwest, Inc. (Fresenius Medical Care Thurston County Dialysis Center)
• Renal Care Group Northwest, Inc. (Olympia Home)
• Allyson Marie Rennie
• Pamela Grace Resendiz, M.S. CCC-SLP
• Victoria Lynn Reyna
• Natalie Rhodes, O.T.R.
• Deborah Rice
• Saska Richards, LMT, LMP

• Internal Medicine Physician in Lacey, WA
• Providers in Lacey, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.