Individual
STACY NICOLE REED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13305 NW CORNELL RD STE C, PORTLAND, OR 97229-5987
(503) 765-5000
(866) 742-0249
Mailing address
13305 NW CORNELL RD STE C, PORTLAND, OR 97229-5987
(503) 765-5000
(866) 742-0249
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD153328
OR
207N00000X
Dermatology Physician
MD60215670
WA
207NS0135X
Procedural Dermatology Physician
MD153328
OR
207NS0135X
Procedural Dermatology Physician
MD60215670
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500646390
—
OR
Enumeration date
05/19/2008
Last updated
10/01/2020
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