Individual
PAUL MICHAEL REARDON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3455 SW VETERANS HOSPITAL RD, PORTLAND, OR 97239-3076
(757) 818-3796
Mailing address
705 NE 73RD AVE, PORTLAND, OR 97213-6217
(757) 818-3796
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
201507280RN
OR
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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