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Kenneth Lee Reckard, PA-C
Medical Physician Assistant in Tualatin, Oregon
NPI 1083635916

Kenneth Lee Reckard is a Medical Physician Assistant based in Portland, OR and is specialized in Medical. Kenneth Lee Reckard practices in Tualatin, OR and has the professional credentials of PA-C. The NPI Number for Kenneth Lee Reckard is 1083635916 and holds a License No. PA01082 (Oregon).

The current practice location address for Kenneth Lee Reckard is 19250 Sw 90Th Ave, Tualatin, OR and can be reached out via phone at 503-692-3750 and via fax at 503-691-2324.

Location: 19250 Sw 90Th Ave, Tualatin, OR, 97232-2684
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Provider Profile Details
NPI Number
1083635916
Provider Name
Kenneth Lee Reckard
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
19250 Sw 90Th Ave, Tualatin, OR, 97232-2684
Phone Number
503-692-3750
Fax Number
503-691-2324
Provider Enumeration Date
07/23/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500604351 05 OR
1083635916 05 WA
institution
Provider Business Practice Location Address Details
Address
19250 Sw 90Th Ave
City
State
Zip
97062-7585
Phone Number
503-692-3750
Fax Number
503-691-2324
person
Provider Business Mailing Address Details
Address
19250 Sw 90Th Ave
City
State
Zip
97062-7585
Phone Number
503-692-3750
Fax Number
503-691-2324
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA01082 (Oregon)
Definition
Definition to come...
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