# RINNOVARE LASER AND WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rinnovare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306003645
- **Authorized official:** MS. HEIDI A WALTER CA (OFFICE MANAGER)
- **Authorized official phone:** (503) 667-9300

## Contact information

- **Practice address:** 23479 SE STARK ST, GRESHAM, OR 97030-2962
- **Practice address phone:** (503) 667-9300
- **Practice address fax:** (503) 667-4975
- **Mailing address:** 23479 SE STARK ST, GRESHAM, OR 97030-2962
- **Mailing address phone:** (503) 667-9300
- **Mailing address fax:** (503) 667-4975

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 3026 | OR | — |
| 175F00000X | Naturopath | 0932 | OR | — |
| 261QM1300X | Multi-Specialty Clinic/Center | 23982 | OR | Yes |

## Other

- **Enumeration date:** 05/22/2008
- **Last updated:** 05/22/2008