Individual provider · Type 1 NPI

Kenneth Lee Reckard, PA-C

Medical Physician Assistant · Tualatin, OR

NPI number 1083635916 Active

Practice location

19250 SW 90th Ave
Tualatin, OR 97062-7585

Call (503) 692-3750 Map

Fax (503) 691-2324

Mailing address

847 NE 19th Ave, Suite 300
Portland, OR 97232-2684

Other practice locations

  • 879 N Providence Dr, Newberg, OR 97132-7563 · (503) 692-3750

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA01082 (OR)

Medical Physician Assistant: Definition to come...

27 other providers at this address

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About NPI 1083635916

Kenneth Lee Reckard, PA-C's National Provider Identifier is 1083635916, issued on Jul 23, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Tualatin, OR. The record was last updated on Dec 1, 2021.