Provider Demographics
NPI:1720452469
Name:REED, ERIN K
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:K
Last Name:REED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 N GRANT ST STE 204
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3600
Mailing Address - Country:US
Mailing Address - Phone:971-917-7881
Mailing Address - Fax:503-506-0499
Practice Address - Street 1:181 N GRANT ST STE 204
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-3600
Practice Address - Country:US
Practice Address - Phone:971-917-7881
Practice Address - Fax:503-506-0499
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORB-10190895103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500797658Medicaid