NPI 1275611501

Jerry L Reams, LMP

Practitioner Contractor Vancouver, WA

Practice location

Address: 1307b NE 78th St. Suite 3, Vancouver, WA 98665
Phone: (360) 573-1933
Fax: (360) 571-0143

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence MA00020315 (WA)

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Registry record

NPI: 1275611501
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Nov 2006
Record last updated: 8 Jul 2007

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.