John Wesley Reilly in Portland - Clinical
John Wesley Reilly - NPI 1417032954
John Wesley Reilly is a Clinical in Portland, Oregon. John Wesley Reilly practices all healthcare services and medical treatments related to Clinical. The NPI Number for John Wesley Reilly is 1417032954. The last update date is 2007-07-08.
John Wesley Reilly's current location address is 12636 Se Stark, Portland, Oregon. You can contact this provider via phone number 5032534600 and fax number 5032534609. The mailing address for John Wesley Reilly is 12636 Se Stark, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John Wesley Reilly |
|---|---|
| Address | 12636 Se Stark, Portland, Oregon |
| Phone Number | 5032534600 |
| Fax Number | 5032534609 |
| Sole Proprietor | N |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1417032954 |
|---|---|
| Provider Enumeration Date | 2006-10-25 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 12636 Se Stark |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 97233 |
| Phone Number | 5032534600 |
| Fax Number | 5032534609 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 1173 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 068WDBBQK | OR | NUMBER PERSONAL MEDICARE | |
| 164936 | OR | -- |
Post Comment/ Review Below
What is the unique identifier code issued to John Wesley Reilly by the Centers for Medicare & Medicaid Services (CMS)?
The John Wesley Reilly has been assigned the NPI (National Provider Identifier) 1417032954. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the John Wesley Reilly located?
The John Wesley Reilly is located at 12636 Se Stark, Portland, OR 97233.
What is John Wesley Reilly's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for John Wesley Reilly is Clinical, and the taxonomy code that classifies this field of practice is 103Tc0700X.
On what date was the 1417032954 assigned to John Wesley Reilly?
The John Wesley Reilly was issued its 1417032954 on 2006-10-25, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to John Wesley Reilly, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to John Wesley Reilly, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2007-07-08.
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