Organization
REGENERATIVE ORTHOPEDIC CENTER LLC
Active
Parent organization
REGENERATIVE ORTHOPEDIC CENTER LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
REGENERATIVE ORTHOPEDIC CENTER LLC
Authorized official
AMANDA KOENIG (COO)
(503) 905-4102
Entity
Organization
Contact information
Practice address
15755 SW SEQUOIA PKWY STE 200, TIGARD, OR 97224-7166
(503) 656-0836
(503) 656-9464
Mailing address
7111 SW NYBERG ST STE 100, TUALATIN, OR 97062-6245
(503) 656-0836
(503) 656-9464
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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