MEDICARE: DR. JOAN LESLIE REEDER MD

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	207R00000X	Internal Medicine Physician	MD22193	OR
2	208M00000X	Hospitalist Physician	MD22193	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831241082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOAN LESLIE REEDER MD

Provider Business Mailing Address
First Line	:	5120 NE 37TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97211-8076
Country	:	US
Telephone Number	:	503-270-9174
Fax Number	:

Provider Business Practice Location Address
First Line	:	5120 NE 37TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97211-8076
Country	:	US
Telephone Number	:	503-270-9174
Fax Number	:

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	05/18/2021

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