Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003309485 |
---|---|
Provider Name | Reece Alexander Lindley |
First Address | Oregon City, OR 97045-2219 |
Second Address | Portland, OR 97215-1548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2018 |
Last Update Date | 11/06/2018 |