Provider Demographics
NPI:1467239863
Name:REIMERS, SHELBY TAYLOR (CNM, ARNP)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:TAYLOR
Last Name:REIMERS
Suffix:
Gender:F
Credentials:CNM, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 32ND AVENUE CT SE
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-2095
Mailing Address - Country:US
Mailing Address - Phone:320-291-8296
Mailing Address - Fax:
Practice Address - Street 1:10004 204TH AVE E STE 2300
Practice Address - Street 2:
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391-6537
Practice Address - Country:US
Practice Address - Phone:253-697-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61475037367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife