Individual
MISS RENEE ERICA BOAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
2908 NE KILLINGSWORTH ST, PORTLAND, OR 97211-6812
(503) 287-8009
(503) 287-7684
Mailing address
1706 SE REEDWAY ST, PORTLAND, OR 97202-5127
(518) 225-2564
(503) 287-7684
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
07/09/2006
Last updated
09/11/2025
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