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1417983198

NPI Code Detail

MEDICARE: JEAN PATRICIA REID MD

MEDICARE: JEAN PATRICIA REID MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD00033023	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0884RE	OTHER	WA	REGENCE BS
2	0190647	OTHER	WA	LABOR & INDUSTRIES
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	91-2145894	OTHER	WA	PREMERA BC QAFM
5	0190647	OTHER	WA	L & I QAFM
6	91-2145894	OTHER	WA	COMMERCIAL QAFM

General Provider Information

NPI Number	:	1417983198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN PATRICIA REID MD

Provider Business Mailing Address
First Line	:	4915 25TH AVE NE STE 102W
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-5667
Country	:	US
Telephone Number	:	206-999-4068
Fax Number	:	206-693-3915

Provider Business Practice Location Address
First Line	:	7520 TOTEM BEACH RD
Second Line	:
City	:	TULALIP
State	:	WA
Zip	:	98271-6160
Country	:	US
Telephone Number	:	360-716-4511
Fax Number	:	360-716-5782

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	01/24/2024

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Directions to “ JEAN PATRICIA REID MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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