Individual provider · Type 1 NPI

Victoria Suzanne Reardon, ATC, LAT

Student in an Organized Health Care Education/Training Program · Portland, OR

NPI number 1821496571 Active

Practice location

2730 S Moody Ave
Portland, OR 97201-5042

Call (509) 200-6090 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1821496571

Victoria Suzanne Reardon, ATC, LAT's National Provider Identifier is 1821496571, issued on Dec 11, 2014. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Portland, OR. The record was last updated on Apr 30, 2026.