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NPI Code Detail

MEDICARE: CHRISTIAN RALPH REYES

MEDICARE: CHRISTIAN RALPH REYES
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
11710I1002XIndependent Duty Corpsman

General Provider Information

NPI Number : 1972270387
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN RALPH REYES
Provider Business Mailing Address
First Line : 1 BOONE RD
Second Line :
City : BREMERTON
State : WA
Zip : 98312-1894
Country : US
Telephone Number : 224-436-1744
Fax Number :
Provider Business Practice Location Address
First Line : 1 BOONE RD
Second Line :
City : BREMERTON
State : WA
Zip : 98312-1894
Country : US
Telephone Number : 360-475-5417
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2021
Last Update Date : 06/25/2026

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Directions to “ CHRISTIAN RALPH REYES ” Practice Location

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