Dominique Kristine Renyer, BA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1027 E Burnside St
Portland, OR 97214

Phone

(503) 239-8400

Fax

(503) 239-8407

NPI assigned

Sep 20, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coda, Inc.

  • Substance Abuse Rehabilitation Facility
  • Portland, OR
  • NPI 1437213865

  Addiction (Substance Use Disorder)

  NPD (past)
• Coda, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Seaside, OR
  • NPI 1750912184
  NPD (past)

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1831407204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97216",
            "telephone_number": "503-239-8400",
            "fax_number": "503-239-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97214",
            "telephone_number": "503-239-8400",
            "fax_number": "503-239-8407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58646 McNulty Way",
            "address_purpose": "LOCATION",
            "city": "Saint Helens",
            "state": "OR",
            "postal_code": "970516210",
            "country_code": "US",
            "telephone_number": "503-397-5211",
            "fax_number": "503-397-5373",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1027 E Burnside St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972141328",
            "country_code": "US",
            "telephone_number": "503-239-8400",
            "fax_number": "503-239-8407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "58646 McNulty Way",
            "address_purpose": "LOCATION",
            "city": "Saint Helens",
            "state": "OR",
            "postal_code": "970516210",
            "country_code": "US",
            "telephone_number": "503-397-5211",
            "fax_number": "503-397-5373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENYER",
        "first_name": "DOMINIQUE",
        "middle_name": "KRISTINE",
        "credential": "BA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-20",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123190",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Marie Renton, DMD
• Lindsay F Rentschler, M.A., BCBA
• Vanessa Christine Rentschler, AU.D., CCC-A
• Shannon Marie Rentz, RD, LD
• Stephen Einar Renwick, MD
• Julia L Reodica, RN, FNP-C
• Repare Massage LLC
• Reperio Health Medical Group, PLLC
• Reperio Health, Inc.
• Marilyn Louise Replogle, M.D.

• Addiction (Substance Use Disorder) Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; 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.