Individual
DR. MARK IRA RECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
812 SW WASHINGTON ST STE 700, PORTLAND, OR 97205-3200
(503) 622-8964
Mailing address
3178 SW 12TH AVE APT 204, PORTLAND, OR 97239-3144
(503) 863-1290
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3539
OR
Other
Enumeration date
04/13/2022
Last updated
04/13/2022
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