Revitalize Wellness Center

NPI #1215394119 in Scappoose, Oregon

Provider Information

NPI Number: 1215394119
Entity Type: Organization
Organization Name: Revitalize Wellness Center
Subpart: Yes (part of a larger organization)
Parent Organization: COLUMBIA COMMUNITY MENTAL HEALTH
Primary Specialty: Clinic/Center - Pain
Enumeration Date: Jan 22, 2016
Last Updated: Aug 28, 2024

Practice Location

Address: 51577 COLUMBIA RIVER HWY
Address 2: SUITE C
City: Scappoose
State: Oregon
ZIP Code: 97056-8409
Phone: (503) 396-4807

Authorized Official

Name: TODD JACOBSON
Title: EXECUTIVE DIRECTOR
Phone: (503) 397-5211

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Pain — Pain	261QP3300X	Primary

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