Healthcare Provider Details

I. General information

NPI: 1952266629
Provider Name (Legal Business Name): MATTHEW REENTS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1666 E OLIVE WAY # 104
SEATTLE WA
98102-5627
US

IV. Provider business mailing address

212 BROADWAY E # 22187
SEATTLE WA
98102-7032
US

V. Phone/Fax

Practice location:
  • Phone: 323-536-2895
  • Fax:
Mailing address:
  • Phone: 323-536-2895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number148044
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number61645066
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: