Provider Demographics
NPI:1134512460
Name:REESE, MATTHEW M (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:M
Last Name:REESE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 T AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-3472
Mailing Address - Country:US
Mailing Address - Phone:206-557-4564
Mailing Address - Fax:206-420-3089
Practice Address - Street 1:3115 T AVE STE 100
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-3472
Practice Address - Country:US
Practice Address - Phone:206-557-4564
Practice Address - Fax:206-420-3089
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60536159111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor