Healthcare Provider Details

I. General information

NPI: 1194631705
Provider Name (Legal Business Name): RENEE C BOWEN RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 NE E ST
GRANTS PASS OR
97526-2326
US

IV. Provider business mailing address

2221 WILLIAMS HWY
GRANTS PASS OR
97527-5687
US

V. Phone/Fax

Practice location:
  • Phone: 541-471-1990
  • Fax:
Mailing address:
  • Phone: 458-229-8291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH7998
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: