Healthcare Provider Details

I. General information

NPI: 1023044021
Provider Name (Legal Business Name): REED E. PAULSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 N SANTIAM HWY
LEBANON OR
97355-4363
US

IV. Provider business mailing address

525 N SANTIAM HWY
LEBANON OR
97355-4363
US

V. Phone/Fax

Practice location:
  • Phone: 541-451-7115
  • Fax: 541-451-7095
Mailing address:
  • Phone: 541-451-7115
  • Fax: 541-451-7095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD19597
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD19597
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberMD19597
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: