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General NPI Number Information
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NPI Number | 1396972519
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Entity Type | Organization
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Legal Business Name | R. GRAHAM REEDY M.D., P.S.
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Dates
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Enumeration Date | 06/15/2009
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Last Update Date | 11/12/2009
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Provider Practice Location Address
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Address Line | 1314 8TH ST NE SUITE 101
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City | AUBURN
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State | WA
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Zip | 98002-4587
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Country | US
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Telephone | 253-804-2788
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Fax | 253-804-2498
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Provider Business Mailing Address
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Address Line | 1314 8TH ST NE SUITE 101
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City | AUBURN
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State | WA
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Zip | 98002-4587
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Country | US
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Telephone | 253-804-2788
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Fax | 253-804-2498
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT GRAHAM REEDY
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Credential | M.D.
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Telephone | 253-804-2788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD00014991
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License Number State | WA
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