MEDICARE: DR. CURTIS DALE REINKE MD

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
1	207R00000X	Internal Medicine Physician	MD00036884	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	126766	OTHER	WA	LABOR AND INDUSTRIES

General Provider Information

NPI Number	:	1609958271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CURTIS DALE REINKE MD

Provider Business Mailing Address
First Line	:	405 BLACK HILLS LN SW STE C
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-8661
Country	:	US
Telephone Number	:	360-956-1725
Fax Number	:	360-705-2557

Provider Business Practice Location Address
First Line	:	405 BLACK HILLS LN SW STE C
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-8661
Country	:	US
Telephone Number	:	360-956-1725
Fax Number	:	360-705-2557

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	07/09/2007

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