Healthcare Provider Details

I. General information

NPI: 1639765316
Provider Name (Legal Business Name): SAMANTHA RENEE REESE DNP, ARNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA RENEE MARIE HARMS

II. Dates (important events)

Enumeration Date: 12/16/2020
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LILLY RD NE, BLDG C
OLYMPIA WA
98506-5080
US

IV. Provider business mailing address

2708 WESTMOOR CT. SW
OLYMPIA WA
98502
US

V. Phone/Fax

Practice location:
  • Phone: 360-918-8336
  • Fax: 360-972-2152
Mailing address:
  • Phone: 360-943-8810
  • Fax: 360-943-0931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP6119245
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61119245
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61119245
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: