Individual
DR. KIM RENAE WENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.,M.P.H.
Contact information
Practice address
2050 PROGRESS WAY, WOODBURN, OR 97071-9764
(503) 981-5348
(503) 981-0423
Mailing address
2050 PROGRESS WAY, WOODBURN, OR 97071-9764
(503) 981-5348
(503) 981-0423
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD28910
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01685249
—
NY
05
—
500603441
—
OR
Enumeration date
07/16/2006
Last updated
04/30/2014
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