Renna, Jeffrey C

Renna, Jeffrey C is an individual health care provider with primary practice located at 1610 12Th St Se , Salem OR 97302-2821. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Renna, Jeffrey C can be contacted via phone (541) 316-6575.

Contact Information

Primary practice address
1610 12Th St Se Salem OR 97302-2821
Phone: (541) 316-6575
Fax: (541) 210-8913
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA60133630 Washington
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA 153839 Oregon

Profile Details

NPI number 1447432190
LBN Legal business name Renna, Jeffrey C
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 4th, 2007
Last updated Jun 27th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447432190 NPPES
Oregon MEDICAID 384377

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