MEDICARE: RAYMONDA REESE

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1932577087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYMONDA REESE

Provider Business Mailing Address
First Line	:	2506 24TH AVE E
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98112-2220
Country	:	US
Telephone Number	:	312-343-0665
Fax Number	:

Provider Business Practice Location Address
First Line	:	2506 24TH AVE E
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98112-2220
Country	:	US
Telephone Number	:	312-343-0665
Fax Number	:

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

Provider Enumeration Date	:	09/07/2015
Last Update Date	:	09/07/2015

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Directions to “ RAYMONDA REESE ” Practice Location

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