Reynolds, Roger
Reynolds, Roger is an individual health care provider with primary practice located at 1825 Maple St , Forest Grove OR 97116-1939. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Reynolds, Roger can be contacted via phone (503) 357-2136.Contact Information
Primary practice address
1825 Maple St
Forest Grove OR 97116-1939
Phone: (503) 357-2136
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | DO18450 | Oregon |
Profile Details
| NPI number | 1689682254 |
|---|---|
| LBN Legal business name | Reynolds, Roger |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2006 |
| Last updated | Jan 10th, 2013 - about 13 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 | 1689682254 | NPPES |
| Oregon | MEDICAID | 56908 |
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