Individual
MS. VICTORIA SUZANNE REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
2730 S MOODY AVE, PORTLAND, OR 97201-5042
(509) 200-6090
Mailing address
2730 S MOODY AVE, PORTLAND, OR 97201-5042
(509) 200-6090
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A160482498
WA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OR
Other
Enumeration date
12/11/2014
Last updated
04/30/2026
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