Provider Demographics
NPI:1962617449
Name:REINLASODER, CAMERON N (LMT)
Entity type:Individual
Prefix:MR
First Name:CAMERON
Middle Name:N
Last Name:REINLASODER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 NW 5TH AVE
Mailing Address - Street 2:#511
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3840
Mailing Address - Country:US
Mailing Address - Phone:503-449-5397
Mailing Address - Fax:
Practice Address - Street 1:221 NW 5TH AVE
Practice Address - Street 2:511
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-3840
Practice Address - Country:US
Practice Address - Phone:503-231-9879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10298174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist