Wentz, Kim Renae

Wentz, Kim Renae is an individual health care provider with primary practice located at 2050 Progress Way , Woodburn OR 97071-9764. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wentz, Kim Renae can be contacted via phone (503) 981-5348.

Contact Information

Primary practice address
2050 Progress Way Woodburn OR 97071-9764
Fax: (503) 981-0423
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD28910 Oregon

Profile Details

NPI number 1962429795
LBN Legal business name Wentz, Kim Renae
Credentials M.D.,M.P.H.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2006
Last updated Apr 30th, 2014 - about 12 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 1962429795 NPPES
New York MEDICAID 01685249
New York MEDICAID 500603441

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