Carol Renne Tanaka, MSN, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP30002123 Issued in WA

Practice address

613 W Gowe St
Kent, WA 98032-5745

Phone

(206) 296-7450

Fax

(206) 205-0750

NPI assigned

Nov 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1720157498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5636 ELIZABETH LOOP SE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980923868",
            "telephone_number": "253-288-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 W GOWE ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980325745",
            "telephone_number": "206-296-7450",
            "fax_number": "206-205-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANAKA",
        "first_name": "CAROL",
        "middle_name": "RENNE",
        "name_prefix": "Ms.",
        "credential": "MSN, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30002123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6911484",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rahul V Tak, PHARM.D
• Marian Midori Takahashi, RPH
• Elizabeth Tale
• Grace D Talic, RN
• Bea Tan
• Steven M. Tanaka, M.D.
• Brandon Tandecki
• Rolando D Tantoco Jr., LMT
• Michael Tartaglia
• Svetlana Tatarinova, LMT

• Family Nurse Practitioner in Kent, WA
• Providers in Kent, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.