Individual
MATHEW REICHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
727 W BURNSIDE ST, PORTLAND, OR 97209-3514
(503) 228-4533
(503) 228-4618
Mailing address
232 NW 6TH AVENUE, ATTN: BBIS CREDENTIALING, PORTLAND, OR 97209
(503) 294-1681
(503) 241-7419
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/25/2018
Last updated
01/25/2018
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