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General NPI Number Information
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NPI Number | 1396789244
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Entity Type | Individual
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Provider Name | STEVEN REYES WOOD IDC
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Gender | Male
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2100 THRESHER AVE USS NEBRASKA SSBN 739 BLUE
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City | SILVERDALE
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State | WA
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Zip | 98315-2103
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Country | US
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Telephone | 360-315-4210
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Fax | 360-396-4247
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Provider Business Mailing Address
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Address Line | 4055 REDWING TRL NW
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City | BREMERTON
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State | WA
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Zip | 98312-9616
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Country | US
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Telephone | 360-315-4210
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Fax | 360-396-4247
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1710I1002X
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Taxonomy Name | Independent Duty Corpsman
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License Number |
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License Number State |
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