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NPI 1760512974

NPI 1760512974 : MR. DAVID REAMER : JACKSONVILLE, OR

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General NPI Number Information
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    NPI Number           |    1760512974
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    Entity Type          |    Individual 
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    Provider Name        |    MR. DAVID REAMER
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/06/2007
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    Last Update Date     |    07/09/2007
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Provider Practice Location Address
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    Address Line         |    675 N 5TH ST STE A 
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    City                 |    JACKSONVILLE
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    State                |    OR
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    Zip                  |    97530-9659
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    Country              |    US
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    Telephone            |    541-899-9194
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    Fax                  |    541-899-1519
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Provider Business Mailing Address
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    Address Line         |    1939 E BURNSIDE ST 
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    City                 |    PORTLAND
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    State                |    OR
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    Zip                  |    97214-1535
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    Country              |    US
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    Telephone            |    503-233-6141
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    Fax                  |    503-233-2889
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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        |    237700000X
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    Taxonomy Name        |    Hearing Instrument Specialist
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    License Number       |    HAS-P-1006131
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    License Number State |    OR
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