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General NPI Number Information
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NPI Number | 1699635631
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Entity Type | Organization
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Legal Business Name | RENEWED LLC
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Dates
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Enumeration Date | 11/13/2025
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 2138 SE SPRUCE ST
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City | HILLSBORO
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State | OR
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Zip | 97123-5029
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Country | US
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Telephone | 971-249-3066
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Fax | 971-249-3066
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Provider Business Mailing Address
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Address Line | 13330 SW GALLOP CT
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City | BEAVERTON
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State | OR
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Zip | 97008-7282
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Country | US
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Telephone | 971-249-3066
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Fax | 971-240-3066
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Authorized Official
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Title or Position | OWNER
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Name | AGNES EMILY ALUOCH
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Credential | CNA
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Telephone | 503-317-4330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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