Provider Demographics
NPI:1467478545
Name:REICHERT, EILEEN MARGARET (ARNP)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:MARGARET
Last Name:REICHERT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 N 59TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-5730
Mailing Address - Country:US
Mailing Address - Phone:206-524-5429
Mailing Address - Fax:
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:CHRMC M/S W7729
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-4127
Practice Address - Fax:206-987-3925
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005215363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9626250Medicaid
AKNP422WAMedicaid
ID805640600Medicaid
MT4307212Medicaid
AKNP422WAMedicaid
ID805640600Medicaid