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Organization

A RENEWAL CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DONNA VIRGINIA WHITMIRE LMHC,CDP,NCGCII/BACC (ADMINISTRATOR,PSYCHOTHERAPIST)
(425) 227-0447
Entity
Organization

Contact information

Practice address
401 OLYMPIA AVE NE STE 318, RENTON, WA 98056-4117
(425) 227-0447
Mailing address
533 REDMOND PL NE, RENTON, WA 98056-3988
(425) 227-0447

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
LH60528456
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110000273418
WA
Enumeration date
10/28/2015
Last updated
10/28/2015
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