MEDICARE: EOWYN A RIEKE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD153861	OR
2	207Q00000X	Family Medicine Physician	MD153881	OR

General Provider Information

NPI Number	:	1366468639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EOWYN A RIEKE M.D.

Provider Business Mailing Address
First Line	:	1312 SW WASHINGTON ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97205-2327
Country	:	US
Telephone Number	:	503-535-1151
Fax Number	:

Provider Business Practice Location Address
First Line	:	1312 SW WASHINGTON ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97205-2327
Country	:	US
Telephone Number	:	503-535-1151
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	08/12/2025

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Directions to “ EOWYN A RIEKE M.D.” Practice Location

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