Provider Demographics
NPI:1588728430
Name:REED, JOHN W
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:W
Last Name:REED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1753 BENTLEY ST E
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH
Mailing Address - State:OR
Mailing Address - Zip Code:97361-1783
Mailing Address - Country:US
Mailing Address - Phone:503-363-0036
Mailing Address - Fax:503-363-2034
Practice Address - Street 1:388 STATE ST
Practice Address - Street 2:SUITE 455
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3532
Practice Address - Country:US
Practice Address - Phone:503-363-0036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker