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NPI Code Detail

MEDICARE: PETER T REISSMANN M.D

MEDICARE:   PETER T REISSMANN  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 PhysicianMD60827333WA
2207R00000XInternal Medicine Physician143046AK
3207RH0000XHematology (Internal Medicine) PhysicianMD60827333WA
4207RH0000XHematology (Internal Medicine) Physician143046AK
5207RH0003XHematology & Oncology PhysicianG57545CA
6207RX0202XMedical Oncology Physician143046AK
7207RX0202XMedical Oncology PhysicianMD60827333WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407891641
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER T REISSMANN M.D
Provider Business Mailing Address
First Line : 1115 SE 164TH AVE DEPT 358
Second Line :
City : VANCOUVER
State : WA
Zip : 98683-8004
Country : US
Telephone Number : 360-729-1462
Fax Number : 360-729-3104
Provider Business Practice Location Address
First Line : 3301 SQUALICUM PKWY
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-1919
Country : US
Telephone Number : 360-788-8222
Fax Number : 360-788-7759
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2006
Last Update Date : 12/02/2019

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Directions to “ PETER T REISSMANN M.D” Practice Location

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