Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Renew Aesthetics and Regenerative Medicine

Organization Integrative Medicine Physician · NPI 1639933286

Renew Aesthetics and Regenerative Medicine is an Integrative Medicine Physician in Puyallup, Washington. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
7

Practice location Address checks out

6302 112th St E Ste 300
Puyallup, WA 98373-4315
Phone: (253) 651-9263
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X
Integrative Medicine Physician Taxonomy 202D00000X
Dermatology Physician Taxonomy 207N00000X
Family Medicine Physician Taxonomy 207Q00000X
Nurse Practitioner Taxonomy 363L00000X
Primary Care Nurse Practitioner Taxonomy 363LP2300X
Women's Health Nurse Practitioner Taxonomy 363LW0102X

Record details

NPI number1639933286
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Lorah — Chief Executive Officer, Clinic Own · (619) 669-8847
NPI enumeratedFebruary 13, 2024
Last updated in NPPESFebruary 13, 2024
Certification dateFebruary 13, 2024
Mailing address16616 139th Ave E, Puyallup, WA 98374-8830

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