Healthcare Provider Details

I. General information

NPI: 1821955444
Provider Name (Legal Business Name): RENEWAL HEALTH SPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 SE CHKALOV DR STE 49
VANCOUVER WA
98683-5277
US

IV. Provider business mailing address

516 SE CHKALOV DR STE 49
VANCOUVER WA
98683-5277
US

V. Phone/Fax

Practice location:
  • Phone: 360-984-7012
  • Fax:
Mailing address:
  • Phone: 360-984-7012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHRISTINA MCCOY
Title or Position: OWNER
Credential: LMT
Phone: 360-984-7012