Provider Demographics
NPI:1154613941
Name:REED, RENEE (MSN,RN,ANP-C,GNP-BC)
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:MSN,RN,ANP-C,GNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13120 SW HEATHER CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-5612
Mailing Address - Country:US
Mailing Address - Phone:503-780-3708
Mailing Address - Fax:503-639-3870
Practice Address - Street 1:11385 SW NOVA CT
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-3922
Practice Address - Country:US
Practice Address - Phone:503-780-3708
Practice Address - Fax:503-639-3870
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR096000646163W00000X
OR201250059NP363LA2200X
OR201250059363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR201250059NPOtherOSBN NP LICENSURE NUMBER