Individual
JAMES EARL REAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1133 NW 21ST AVE, PORTLAND, OR 97209-1513
(503) 222-5010
Mailing address
2056 NW FLANDERS ST APT 3, PORTLAND, OR 97209-1135
(503) 936-0938
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
666
OR
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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