Healthcare Provider Details

I. General information

NPI: 1427673227
Provider Name (Legal Business Name): ANTHONY EUGENE REESER RA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2020
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 COUNTRY CLUB RD STE 222
EUGENE OR
97401-2238
US

IV. Provider business mailing address

655 GOODPASTURE ISLAND RD APT 65
EUGENE OR
97401-1530
US

V. Phone/Fax

Practice location:
  • Phone: 541-686-6000
  • Fax:
Mailing address:
  • Phone: 541-554-4460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: