Individual
MICHAEL BRUCE REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
36 SW NYE ST, NEWPORT, OR 97365-3821
(541) 265-4947
Mailing address
36 SW NYE ST, NEWPORT, OR 97365-3821
(541) 265-0445
(844) 760-0526
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10035532
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
95025779
CA
363LP2300X
Primary Care Nurse Practitioner
95025779
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500852591
—
OR
Enumeration date
12/19/2022
Last updated
02/24/2026
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