Provider Demographics
NPI:1386020626
Name:REICHERT, NADENE (MFT-A)
Entity Type:Individual
Prefix:
First Name:NADENE
Middle Name:
Last Name:REICHERT
Suffix:
Gender:F
Credentials:MFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 IRIS DR APT 3
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517-3286
Mailing Address - Country:US
Mailing Address - Phone:206-909-9728
Mailing Address - Fax:
Practice Address - Street 1:2520 NE MULBERRY WALK
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029-7369
Practice Address - Country:US
Practice Address - Phone:206-909-9728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK102571106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK102571OtherMFT-A
WAMG61072492OtherLMFT-A