| Dr. Laura Renteria, Pc | |
|
14631 Sw Millikan Way Beaverton OR 97003-2999 | |
| (971) 330-7352 | |
| Not Available |
| Full Name | Dr. Laura Renteria, Pc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 14631 Sw Millikan Way, Beaverton, Oregon |
| Authorized Official Name and Position | Laura Renteria (OWNER) |
| Authorized Official Contact | 9713307352 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Laura Renteria, Pc 14631 Sw Millikan Way Beaverton OR 97003-2999 Ph: (971) 330-7352 | Dr. Laura Renteria, Pc 14631 Sw Millikan Way Beaverton OR 97003-2999 Ph: (971) 330-7352 |
| NPI Number | 1952844979 |
|---|---|
| Provider Enumeration Date | 11/22/2016 |
| Last Update Date | 11/22/2016 |
| Medicare PECOS PAC ID | 0749569259 |
|---|---|
| Medicare Enrollment ID | O20161125000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952844979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 2686 (Oregon) | Primary |
| Provider Name | Haley Gail Trontel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538582903 PECOS PAC ID: 4587976063 Enrollment ID: I20150713000879 |
| Provider Name | Laura Renteria |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205046422 PECOS PAC ID: 4284734666 Enrollment ID: I20161114000424 |
| Provider Name | Natasha D White |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194197640 PECOS PAC ID: 5092143610 Enrollment ID: I20201021002726 |
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