Healthcare Provider Details

I. General information

NPI: 1831185347
Provider Name (Legal Business Name): MARK A REED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 03/27/2020
Certification Date: 03/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

963 SE CAMANO DR
CAMANO ISLAND WA
98282-8489
US

IV. Provider business mailing address

963 SE CAMANO DR
CAMANO ISLAND WA
98282-8489
US

V. Phone/Fax

Practice location:
  • Phone: 206-419-7297
  • Fax:
Mailing address:
  • Phone: 206-419-7297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberE3497
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: