Reed, Stacy Nicole
Reed, Stacy Nicole is an sole proprietor health care provider with primary practice located at 13305 Nw Cornell Rd Ste C , Portland OR 97229-5987. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Procedural Dermatology, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Reed, Stacy Nicole can be contacted via phone (503) 765-5000.Contact Information
Primary practice address
13305 Nw Cornell Rd Ste C
Portland OR 97229-5987
Phone: (503) 765-5000
Fax: (866) 742-0249
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | MD60215670 | Washington |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD60215670 | Washington |
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | MD153328 | Oregon |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD153328 | Oregon |
Profile Details
| NPI number | 1285891168 |
|---|---|
| LBN Legal business name | Reed, Stacy Nicole |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 19th, 2008 |
| Last updated | Oct 1st, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285891168 | NPPES |
| Oregon | MEDICAID | 500646390 |
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