Individual
MONIQUE REINA REAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
600 NE 8TH ST, GRESHAM, OR 97030-7317
(503) 988-5155
Mailing address
435 N 5TH ST, PHOENIX, AZ 85004-2157
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA213682
OR
Other
Enumeration date
06/03/2022
Last updated
11/04/2023
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