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NPI Code Detail

MEDICARE: LYNN REILLY M.D.

MEDICARE: LYNN REILLY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD00041244WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00319570OTHERWARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1152867OTHERCACA STATE LICENSE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134103765
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNN REILLY M.D.
Provider Business Mailing Address
First Line : 12342 RIVIERA PL NE
Second Line :
City : SEATTLE
State : WA
Zip : 98125-5965
Country : US
Telephone Number : 206-851-8571
Fax Number :
Provider Business Practice Location Address
First Line : 3610 AMERICAN RIVER DR STE 140
Second Line :
City : SACRAMENTO
State : CA
Zip : 95864-5919
Country : US
Telephone Number : 206-851-8571
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2005
Last Update Date : 04/07/2021

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