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General NPI Number Information
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NPI Number | 1952712093
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Entity Type | Individual
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Provider Name | TESSA MARIE REINKE MD
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Gender | Female
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Dates
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Enumeration Date | 05/12/2014
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 414 CHURCH ST STE 120
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City | SANDPOINT
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State | ID
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Zip | 83864-7065
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Country | US
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Telephone | 208-265-2221
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Fax |
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Provider Business Mailing Address
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Address Line | 414 CHURCH ST STE 120
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City | SANDPOINT
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State | ID
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Zip | 83864-7065
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Country | US
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Telephone | 208-265-2221
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD60729630
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M-14107
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License Number State | ID
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