Individual
TRACY REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5100 SW MACADAM AVE, SUITE 400, PORTLAND, OR 97239-6102
(503) 244-5211
(503) 244-5506
Mailing address
5100 SW MACADAM AVE, SUITE 400, PORTLAND, OR 97239-6102
(503) 244-5211
(503) 244-5506
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/03/2015
Last updated
11/03/2015
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