Individual
ELIZAVETA REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13248 ROGERS RD, LAKE OSWEGO, OR 97035-6752
(917) 539-9098
Mailing address
13248 ROGERS RD, LAKE OSWEGO, OR 97035-6752
(917) 539-9098
Taxonomy
Speciality
Code
Description
License number
State
207RI0001X
Clinical & Laboratory Immunology (Internal Medicine) Physician
Primary
38D2237496
OR
Other
Enumeration date
10/14/2021
Last updated
10/14/2021
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