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General NPI Number Information
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NPI Number | 1609958271
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Entity Type | Individual
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Provider Name | CURTIS DALE REINKE MD
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Gender | Male
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 405 BLACK HILLS LN SW STE C
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City | OLYMPIA
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State | WA
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Zip | 98502-8661
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Country | US
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Telephone | 360-956-1725
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Fax | 360-705-2557
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Provider Business Mailing Address
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Address Line | 405 BLACK HILLS LN SW STE C
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City | OLYMPIA
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State | WA
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Zip | 98502-8661
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Country | US
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Telephone | 360-956-1725
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Fax | 360-705-2557
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD00036884
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License Number State | WA
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Legacy Identifiers
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Identifier #1
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Identifier Code | 1106814
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Identifier Type | MEDICAID
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Identifier State | WA
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Identifier Issuer |
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Identifier #2
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Identifier Code | 126766
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Identifier Type | OTHER
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Identifier State | WA
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Identifier Issuer | LABOR AND INDUSTRIES
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 1106814
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Identifier Type | MEDICAID
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Identifier State | WA
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Identifier Issuer |
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Identifier #2
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Identifier Code | 126766
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Identifier Type | OTHER
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Identifier State | WA
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Identifier Issuer | LABOR AND INDUSTRIES
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