Individual
BOONE REAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25117 SW PARKWAY AVE, STE D, WILSONVILLE, OR 97070-9697
(971) 244-2040
Mailing address
1009 NE 47TH AVE, #12, PORTLAND, OR 97213-2218
(971) 570-0537
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
05/11/2015
Last updated
05/11/2015
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