Provider Demographics
NPI:1114037454
Name:REINKE, CARLA (ARNP,CNM)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:REINKE
Suffix:
Gender:F
Credentials:ARNP,CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 SPRUCE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2474
Mailing Address - Country:US
Mailing Address - Phone:206-461-6935
Mailing Address - Fax:206-461-8382
Practice Address - Street 1:201 16TH AVE E MSC CWB-2
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5226
Practice Address - Country:US
Practice Address - Phone:206-324-1449
Practice Address - Fax:206-324-6977
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00080198163WW0101X
WAAP3000951363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
Not Answered363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9617770Medicaid
WA8800413Medicare ID - Type UnspecifiedHIPT
WAAB34667Medicare ID - Type UnspecifiedRNPK
WA9617770Medicaid
WA8800615Medicare ID - Type UnspecifiedMFFC
WA8800411Medicare ID - Type UnspecifiedGWMC
WAAB28579Medicare ID - Type UnspecifiedMDWF
WA880409`Medicare ID - Type UnspecifiedRBMC