RINNOVARE LASER AND WELLNESS NPI 1306003645

NPI Information

  • NPI: 1306003645
  • Provider Name: RINNOVARE LASER AND WELLNESS
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • Former Legal Business Name: RINNOVARE
  • Address: 23479 SE STARK ST
    GRESHAM, OR
    ZIP 97030
  • Phone: (503) 667-9300

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NPI Details

RINNOVARE LASER AND WELLNESS is a multi-specialty clinic center in Gresham, OR. RINNOVARE LASER AND WELLNESS NPI is 1306003645. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Rinnovare.

The provider's business location address is:

23479 SE STARK ST
GRESHAM, OR
ZIP 97030-962
Phone: (503) 667-9300
Fax: (503) 667-4975

The provider's authorized official is Heidi A Walter .
The authorized official title is Office Manager and has the following contact phone number (503) 667-9300.

The enumeration date for this NPI number is 5/22/2008 and was last updated on 5/22/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractor3026OREGONNo
2175F00000XNaturopath0932OREGONNo
3261QM1300XClinic/CenterMulti-Specialty23982OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1U72454MEDICARE UPINOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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