Individual
JEFFREY C RENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1011 COMMERCIAL ST NE STE 110, SALEM, OR 97301-1036
(503) 983-9900
(503) 983-9899
Mailing address
1011 COMMERCIAL ST NE STE 110, SALEM, OR 97301-1036
(503) 983-9900
(503) 983-9899
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 153839
OR
363AM0700X
Medical Physician Assistant
PA60133630
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
384377
—
OR
05
—
500637318
—
OR
Enumeration date
12/04/2007
Last updated
11/20/2025
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