| Renew Family Medicine Llc | |
|
1975 Nw 167th Pl Ste 100-46 Beaverton OR 97006-4908 | |
| (971) 238-2330 | |
| Not Available |
| Full Name | Renew Family Medicine Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1975 Nw 167th Pl Ste 100-46, Beaverton, Oregon |
| Authorized Official Name and Position | Van Anh Nguyen (OWNER, PHYSICIAN) |
| Authorized Official Contact | 9712228750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Family Medicine Llc 1975 Nw 167th Pl Ste 100-46 Beaverton OR 97006-4908 Ph: (971) 238-2330 | Renew Family Medicine Llc 1975 Nw 167th Pl Ste 100-46 Beaverton OR 97006-4908 Ph: (971) 238-2330 |
| NPI Number | 1477251221 |
|---|---|
| Provider Enumeration Date | 02/21/2023 |
| Last Update Date | 04/12/2023 |
| Medicare PECOS PAC ID | 9537534003 |
|---|---|
| Medicare Enrollment ID | O20230414001091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477251221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Van Anh Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053724013 PECOS PAC ID: 0941575666 Enrollment ID: I20171005003081 |
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