MEDICARE: TANIA ELIZABETH VILLANUEVA REYES

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
1	172V00000X	Community Health Worker		OR

General Provider Information

NPI Number	:	1477400018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANIA ELIZABETH VILLANUEVA REYES

Provider Business Mailing Address
First Line	:	333 SE 7TH AVE STE 5500
Second Line	:
City	:	HILLSBORO
State	:	OR
Zip	:	97123-4185
Country	:	US
Telephone Number	:	503-597-4500
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 SE 7TH AVE STE 5500
Second Line	:
City	:	HILLSBORO
State	:	OR
Zip	:	97123-4185
Country	:	US
Telephone Number	:	503-597-4500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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