REGAN REA P.A.C NPI 1780773150

NPI Information

NPI: 1780773150
Provider Name: REGAN REA, P.A.C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
4920 N INTERSTATE AVE
PORTLAND, OR
ZIP 97217
Phone: (503) 215-3300
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Regan Rea, P.A.C is a medical physician assistant in Portland, OR. Regan Rea, P.A.C NPI is 1780773150. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4920 N INTERSTATE AVE
PORTLAND, OR
ZIP 97217-653
Phone: (503) 215-3300

The enumeration date for this NPI number is 10/12/2006 and was last updated on 11/8/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA00721	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P34412	MEDICARE UPIN
2	R109785	MEDICARE ID-TYPE UNSPECIFIED
3	500604207	MEDICAID	OREGON
4	067463008	OTHER	OREGON	REGENCE
5	P00069863	MEDICARE ID-TYPE UNSPECIFIED		RR MEDICARE
6	911019392	OTHER		COMMERCIAL
7	M0665 17	OTHER		PACIFIC SOURCE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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