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NPI Code Detail

MEDICARE: KEVIN RENTZ

MEDICARE: KEVIN RENTZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1588728901
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN RENTZ
Provider Business Mailing Address
First Line : 182 SW ACADEMY ST
Second Line :
City : DALLAS
State : OR
Zip : 97338-1996
Country : US
Telephone Number : 503-623-9289
Fax Number : 503-831-1726
Provider Business Practice Location Address
First Line : 182 SW ACADEMY ST
Second Line :
City : DALLAS
State : OR
Zip : 97338-1996
Country : US
Telephone Number : 503-623-9289
Fax Number : 503-831-1726
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 09/21/2018

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Directions to “ KEVIN RENTZ ” Practice Location

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