NPIMap

Organization Active NPI

Rinnovare Laser and Wellness

  • Multi-Specialty Clinic/Center
  • Gresham, OR
National Provider Identifier
1306003645
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
23982 Issued in OR
Legal business name
RINNOVARE LASER AND WELLNESS
Practice address
23479 SE Stark St
Gresham, OR 97030-2962
Phone
(503) 667-9300
Fax
(503) 667-4975
NPI assigned
May 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Authorized official

Name
Ms. Heidi A Walter, CA
Title
Office Manager
Phone
(503) 667-9300

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 3026 OR
NaturopathGroup: 193200000X MULTI-SPECIALTY GROUP 175F00000X 0932 OR
Multi-Specialty Clinic/Center 261QM1300X 23982 OR Primary

Addresses

Primary practice location

23479 SE Stark St
Gresham, OR 97030-2962

Mailing address

23479 SE Stark St
Gresham, OR 97030-2962
Phone (503) 667-9300

Other names 1

  • Rinnovare Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1306003645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23479 SE STARK ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970302962",
            "telephone_number": "503-667-9300",
            "fax_number": "503-667-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23479 SE STARK ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970302962",
            "telephone_number": "503-667-9300",
            "fax_number": "503-667-4975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RINNOVARE LASER AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-667-9300",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CA"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3026",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": "OR",
            "license": "0932",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "OR",
            "license": "23982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rinnovare",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.