Individual
CAROLINE REAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5330 NE GLISAN ST, SUITE 100, PORTLAND, OR 97213-3069
(503) 215-9700
(503) 215-9701
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD17393
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060199
—
OR
01
—
110189270
RR MEDICARE
OR
Enumeration date
07/07/2006
Last updated
03/24/2021
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