Individual
JOSHUA D REAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10330 SE 32ND AVE, SUITE 205, MILWAUKIE, OR 97222-6594
(503) 513-8950
(503) 772-4337
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD23905
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0186583
WA DEPT. OF L&I
WA
05
—
226869
—
OR
Enumeration date
02/22/2006
Last updated
10/06/2020
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