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NPI Code Detail

MEDICARE: SUSAN V. REYES-TORRES LMSW

MEDICARE: SUSAN V. REYES-TORRES LMSW
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
1101Y00000XCounselorM-08186NM
2106S00000XBehavior Technician
31041C0700XClinical Social WorkerM-08186NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366775504
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN V. REYES-TORRES LMSW
Provider Business Mailing Address
First Line : 2636 SW 186TH PL
Second Line :
City : ALOHA
State : OR
Zip : 97003-3559
Country : US
Telephone Number : 626-607-6935
Fax Number :
Provider Business Practice Location Address
First Line : 6200 SW ARCTIC DR
Second Line :
City : BEAVERTON
State : OR
Zip : 97005-9447
Country : US
Telephone Number : 503-224-2184
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2009
Last Update Date : 07/19/2019

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