Healthcare Provider Details

I. General information

NPI: 1871401828
Provider Name (Legal Business Name): SAVANNAH MARIE REYES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 NE 136TH AVE STE 220
VANCOUVER WA
98684-6951
US

IV. Provider business mailing address

404 NE 117TH AVE # F45
VANCOUVER WA
98684-5026
US

V. Phone/Fax

Practice location:
  • Phone: 206-565-7101
  • Fax: 360-952-7060
Mailing address:
  • Phone: 206-565-7101
  • Fax: 206-565-7101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: