Provider Demographics
NPI:1437466604
Name:REED, DUSTIN ALAN (PHARMD, PA-C)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:ALAN
Last Name:REED
Suffix:
Gender:M
Credentials:PHARMD, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-4310
Mailing Address - Country:US
Mailing Address - Phone:205-533-4312
Mailing Address - Fax:813-533-5511
Practice Address - Street 1:21616 76TH AVENUE WEST
Practice Address - Street 2:SUITE 102
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026
Practice Address - Country:US
Practice Address - Phone:425-774-1538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15687183500000X
WAPH60136177183500000X
FLPA9113147363A00000X
WAPA60135328363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
No183500000XPharmacy Service ProvidersPharmacist