Provider Demographics
NPI:1851793814
Name:GARRISON BOWER, REINA (CRM)
Entity Type:Individual
Prefix:MISS
First Name:REINA
Middle Name:
Last Name:GARRISON BOWER
Suffix:
Gender:F
Credentials:CRM
Other - Prefix:
Other - First Name:REINA
Other - Middle Name:
Other - Last Name:GARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2051 KAEN RD
Mailing Address - Street 2:SUITE 367
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-4035
Mailing Address - Country:US
Mailing Address - Phone:503-655-8401
Mailing Address - Fax:503-655-8429
Practice Address - Street 1:998 LIBRARY CT
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-4041
Practice Address - Country:US
Practice Address - Phone:503-655-8401
Practice Address - Fax:503-655-8429
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-22
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13-CRM-068171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator