Organization
AGEWELL GERIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE LADENE REED ANP-C, GNP-BC (OWNER/NURSE PRACTITIONER)
(503) 780-3708
Entity
Organization
Contact information
Practice address
13120 SW HEATHER CT, BEAVERTON, OR 97008-5612
(503) 780-3708
(503) 639-3870
Mailing address
13120 SW HEATHER CT, BEAVERTON, OR 97008-5612
(503) 780-3708
(503) 639-3870
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154613941
NPI
—
05
—
500698230
—
OR
Enumeration date
06/17/2019
Last updated
06/17/2019
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