Provider Demographics
NPI:1407082563
Name:FEIDER, REENA P (DDS)
Entity Type:Individual
Prefix:DR
First Name:REENA
Middle Name:P
Last Name:FEIDER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 1ST ST
Mailing Address - Street 2:UNIT 206
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-6169
Mailing Address - Country:US
Mailing Address - Phone:858-752-2180
Mailing Address - Fax:
Practice Address - Street 1:5726 LAKE WASHINGTON BLVD NE
Practice Address - Street 2:S-2
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7425
Practice Address - Country:US
Practice Address - Phone:425-284-0515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9022122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist