Individual
DR. MARK D. RELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
707 SW GAINES ST, CDRC-P, PORTLAND, OR 97239-2901
(503) 494-2192
(503) 494-2824
Mailing address
707 SW GAINES ST, CDRC-P, PORTLAND, OR 97239-2901
(503) 494-2192
(503) 494-2824
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD13950
OR
2080P0202X
Pediatric Cardiology Physician
Primary
MD13950
OR
Other
Enumeration date
06/18/2006
Last updated
11/18/2011
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