Individual
MR. RICCO CORY REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363LF0000X
Family Nurse Practitioner
Primary
202213334NP-PP
OR
363LF0000X
Family Nurse Practitioner
API61363661
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202213334NP-PP
OREGON STATE BOARD OF NURSING
OR
01
—
AP61363661
WASHINGTON DEPARTMENT OF HEALTH
WA
Enumeration date
10/22/2020
Last updated
10/26/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us