MEDICARE: DR. LORA E REIF PH.D.

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	103T00000X	Psychologist	PY2605	WA

General Provider Information

NPI Number	:	1558648824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORA E REIF PH.D.

Provider Business Mailing Address
First Line	:	11522 NE 21ST ST
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98004-3025
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11522 NE 21ST ST
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98004-3025
Country	:	US
Telephone Number	:	425-467-9335
Fax Number	:

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

Provider Enumeration Date	:	11/14/2011
Last Update Date	:	11/14/2011

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Directions to “ DR. LORA E REIF PH.D.” Practice Location

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