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General NPI Number Information
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NPI Number | 1558369959
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Entity Type | Individual
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Provider Name | BLAKE E. REITER M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 04/21/2014
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Provider Practice Location Address
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Address Line | 9800 LEVIN RD NW SUITE 102
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City | SILVERDALE
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State | WA
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Zip | 98383-7849
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Country | US
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Telephone | 360-692-2728
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Fax | 360-692-6009
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Provider Business Mailing Address
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Address Line | 16499 PEARSON POINT RD NE
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City | POULSBO
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State | WA
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Zip | 98370-8058
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Country | US
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Telephone | 360-271-2846
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD00023941
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License Number State | WA
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