Healthcare Provider Details

I. General information

NPI: 1093386708
Provider Name (Legal Business Name): SCOTT R REETZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2021
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

7710 MERCY RD STE 202
OMAHA NE
68124-2353
US

V. Phone/Fax

Practice location:
  • Phone: 206-618-9838
  • Fax:
Mailing address:
  • Phone: 402-280-4669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number70080479
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: