Individual
PAUL REVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2525 PORTLAND ST APT 19, EUGENE, OR 97405-3107
(541) 232-8513
Mailing address
2525 PORTLAND ST APT 19, EUGENE, OR 97405-3107
(541) 232-8513
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/03/2014
Last updated
12/03/2014
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