Elizaveta Reynolds

Primary specialty

Clinical & Laboratory Immunology (Internal Medicine) PhysicianTaxonomy code 207RI0001X

License

38D2237496 Issued in OR

Practice address

13248 Rogers Rd
Lake Oswego, OR 97035-6752

Phone

(917) 539-9098

NPI assigned

Oct 14, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clearblue Labs

  • Clinical & Laboratory Immunology (Internal Medicine) Physician
  • Lake Oswego, OR
  • NPI 1821753070
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1497418651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13248 ROGERS RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970356752",
            "telephone_number": "917-539-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13248 ROGERS RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970356752",
            "telephone_number": "917-539-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ELIZAVETA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical & Laboratory Immunology",
            "state": "OR",
            "license": "38D2237496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cbluelabs.com",
            "affiliation": "N",
            "endpointDescription": "online portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13248 Rogers Rd",
            "city": "Lake Oswego",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970356752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hunter Renish
• Restorative Health Clinic
• Restorative Health Clinic, LLC
• Jaquelyn Victoria Reyes Alonzo
• Abelina I Reyes, RN
• Melinda Reynolds, LPC
• RF Heikens Enterprises, Inc
• Joseph P Rhinewine, PH.D.
• Dale V Rhoney, DDS PC
• Kay Susan Rhoney, OTR

• Internal Medicine Physician in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.