Healthcare Provider Details

I. General information

NPI: 1588244610
Provider Name (Legal Business Name): RENEMA REID NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2095 EXCHANGE ST STE 301
ASTORIA OR
97103-3400
US

IV. Provider business mailing address

2111 EXCHANGE ST
ASTORIA OR
97103-3329
US

V. Phone/Fax

Practice location:
  • Phone: 503-338-4087
  • Fax: 503-338-4091
Mailing address:
  • Phone: 503-325-4321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10044419
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number346518
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: