NPI 1043551930

Reda Tawfik Bassaly, PAC

Practitioner Medical Physician Assistant Lebanon, OR

Practice location

Address: 325 Park St, Lebanon, OR 97355-4229
Phone: (541) 451-7200
Mailing address: PO Box 1189, Corvallis, OR 97339-1189

Registered specialties (2)

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence PA163414 (OR)

Other Physician Assistant providers in Oregon →

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA163414 (OR)

Registry record

NPI: 1043551930
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Mar 2013
Record last updated: 6 Oct 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.