Individual
RENAE RYKACZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
600 NE 8TH ST STE 300, GRESHAM, OR 97030-7318
(530) 988-5155
Mailing address
6120 N CONCORD AVE, PORTLAND, OR 97217-4735
(323) 580-9119
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201807432NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053895110
—
OR
Enumeration date
09/24/2018
Last updated
07/01/2019
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