NPI | 1063777415 |
---|---|
Other Name | RENEW CLINIC & SPA |
Entity Type | Organization |
Authorized Contact | JOANNE ENGEL KORT Certified Nurse Practitioner 503-269-3495 |
Organization Subpart ? | No |
Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: OR MD18043) |
Enumeration Date | 2012-07-11 |
Last Update Date | 2023-03-07 |