Individual
DR. STEPHEN ALEXANDER RELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
16703 SE MCGILLIVRAY BLVD STE 100, VANCOUVER, WA 98683-3418
(503) 477-1897
Mailing address
19111 NE 24TH ST, VANCOUVER, WA 98684-1818
(503) 477-1897
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10682
OR
122300000X
Dentist
DE61315076
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
OR
Other
Enumeration date
05/30/2017
Last updated
09/06/2022
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