Provider Demographics
NPI:1174199012
Name:REED, EMILY M (LMT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:REED
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:M
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6802 SW CANYON RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-3613
Mailing Address - Country:US
Mailing Address - Phone:714-333-6552
Mailing Address - Fax:
Practice Address - Street 1:6802 SW CANYON RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-3613
Practice Address - Country:US
Practice Address - Phone:714-333-6552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR26032225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist