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General NPI Number Information
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NPI Number | 1679758064
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Entity Type | Individual
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Provider Name | AMY ELIZABETH REYNOLDS D.C.
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Gender | Female
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 428 NE 4TH AVE
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City | CAMAS
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State | WA
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Zip | 98607-2128
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Country | US
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Telephone | 360-834-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 428 NE 4TH AVE
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City | CAMAS
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State | WA
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Zip | 98607-2128
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Country | US
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Telephone | 360-834-7300
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Fax | 360-210-4345
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 25265
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH60959665
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License Number State | WA
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