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NPI Code Detail

MEDICARE: ABIMELEC REYES

MEDICARE: ABIMELEC REYES
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1487335998
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIMELEC REYES
Provider Business Mailing Address
First Line : 14725 SE RHONE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97236-2556
Country : US
Telephone Number : 971-314-0144
Fax Number : 971-200-2073
Provider Business Practice Location Address
First Line : 14725 SE RHONE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97236-2556
Country : US
Telephone Number : 971-314-0144
Fax Number : 971-200-2073
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2023
Last Update Date : 07/27/2023

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Directions to “ ABIMELEC REYES ” Practice Location

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