Organization
RENEW THERAPY NW
Active
Other names
Renew Therapy NW LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ANN JIM LPC (OWNER)
(503) 446-2024
Entity
Organization
Contact information
Practice address
9400 SW BEAVERTON HILLSDALE HWY STE 204, BEAVERTON, OR 97005-3315
(503) 446-2024
Mailing address
9400 SW BEAVERTON HILLSDALE HWY STE 250, BEAVERTON, OR 97005-3300
(503) 446-2024
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144535162
—
OR
Enumeration date
02/14/2022
Last updated
09/10/2024
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