Provider Demographics
NPI:1073039467
Name:REINHARDT, CATHERINE (LPN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:REINHARDT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 21ST AVE APT 12
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2868
Mailing Address - Country:US
Mailing Address - Phone:360-932-2546
Mailing Address - Fax:
Practice Address - Street 1:462 PEPPERMILL RD
Practice Address - Street 2:
Practice Address - City:KELSO
Practice Address - State:WA
Practice Address - Zip Code:98626-8831
Practice Address - Country:US
Practice Address - Phone:360-932-2546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP60712814163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse