Individual
MR. DAVID RAUL REAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
875 OAK ST SE, STE 3010, SALEM, OR 97301
(503) 399-7520
(503) 362-7344
Mailing address
2480 LIBERTY ST NE, STE 180, SALEM, OR 97301-8388
(503) 399-7520
(503) 362-7344
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01357
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306005681
—
WA
05
—
500603869
—
OR
Enumeration date
06/03/2008
Last updated
06/02/2021
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