JOHN WESLEY REILLY PHD
NPI 1417032954
Psychologist - Clinical in Portland, OR

Q: What is John Reilly's NPI number?

The NPI number for John Reilly is 1417032954. It was assigned to this individual provider in the NPPES registry on October 25, 2006.

Q: What is John Reilly's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for John Reilly was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 25, 2006

12636 SE STARK, PORTLAND, OR 97233(503) 253-4600(503) 253-4609 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About John Wesley Reilly Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN WESLEY REILLY PHD (NPI 1417032954) is an individual clinical provider in Portland, Oregon, licensed in Oregon (1173) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1417032954

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameJOHN WESLEY REILLYCredential: PHD

Location Address12636 SE STARKPortland, OR 97233

Mailing AddressPo Box 82819Portland, OR 97282 · (503) 233-5405 · Fax (503) 233-2696

Phone(503) 253-4600

Fax(503) 253-4609

Sole ProprietorNo

Enumeration DateOctober 25, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1417032954 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in OR · 1173

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

12636 SE STARK, Portland, OR 97233

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Other Identifiers 3

Medicaid164936OR

Other068WDBBQKOR · Number Personal Medicare

Medicare ID-Type Unspecified0000WDBCHOR · Group Number

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Reilly's NPI number?

The NPI number for John Reilly is 1417032954. It was assigned to this individual provider in the NPPES registry on October 25, 2006.

Where is John Reilly located?

John Reilly practices at 12636 SE Stark, Portland, OR 97233. The listed phone number is (503) 253-4600.

What is John Reilly's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for John Reilly was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.