Renew Aesthetics and Regenerative Medicine

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

RENEW AESTHETICS AND REGENERATIVE MEDICINE

Practice address

6302 112TH St E Ste 300
Puyallup, WA 98373-4315

Phone

(253) 651-9263

NPI assigned

Feb 13, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Michael Lorah

Title

Chief Executive Officer, Clinic Own

Phone

(619) 669-8847

Specialties & licenses 7

Addresses

Practitioners 1

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

• Maria Isabel Lorah, ARNP, NP-C, COHN-S

  • Family Nurse Practitioner
  • Puyallup, WA
  • NPI 1720437858
  NPD

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1639933286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16616 139TH AVE E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748830",
            "telephone_number": "619-669-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6302 112TH ST E STE 300",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983734315",
            "telephone_number": "253-651-9263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW AESTHETICS AND REGENERATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "LORAH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER, CLINIC OWN",
        "authorized_official_telephone_number": "619-669-8847",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "202D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Integrative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy E Reim
• Alison Jean Reinbold, M.D.
• Henry C Reitzug, M.D.
• Relatyv Mobile Medical LLC
• Renal Care Group Northwest, Inc.
• Rashaun A Renggli
• Shannon Renich
• Renn Chiropractic PS
• Timothy G Renn, D.C.
• Renton Vision Center Inc PS

• Clinic/Center in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.