NPI 1457723587

A Renewal Center LLC

Organisation Exclusive Provider Organization Renton, WA

Practice location

Address: 401 Olympia Ave NE STE 318, Renton, WA 98056-4117
Phone: (425) 227-0447
Mailing address: 533 Redmond Pl NE, Renton, WA 98056-3988

Authorised official

Name: Donna Virginia Whitmire
Title: Administrator,psychotherapist
Phone: (425) 227-0447

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence LH60528456 (WA)

Other Exclusive Provider Organization providers in Washington →

Registry record

NPI: 1457723587
Entity type: Organization
NPI issued: 28 Oct 2015
Record last updated: 28 Oct 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.