| Doctor Name: | BREANNE ROHDE |
| NPI Number: | 1003050071 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA 60234603 |
| Business Practice Address: | 200 Ne Mother Joseph Pl Suite 210 Vancouver, WA - 986643299 |
| Business Phone Number: | 3602546161 |
| Business Fax Number: | 3604491139 |
| Mailing Address: | 200 Ne Mother Joseph Pl, Suite 210 VANCOUVER |
| State: | WA |
| Postal Code: | 986643299 |
| Phone Number: | 3602546161 |
| Fax Number: | 3604491139 |
| NPI Enumeration Date: | 04/22/2009 |
| NPI Last Update Date: | 08/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | PA 60234603 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |