Provider Demographics
NPI:1467752659
Name:CYNTHIA M. DE LOS REYES, MD, PLLC
Entity Type:Organization
Organization Name:CYNTHIA M. DE LOS REYES, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:MARCELO
Authorized Official - Last Name:DE LOS REYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-582-3571
Mailing Address - Street 1:923 SOUTH AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336
Mailing Address - Country:US
Mailing Address - Phone:509-582-3571
Mailing Address - Fax:509-586-4383
Practice Address - Street 1:923 SOUTH AUBURN ST
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336
Practice Address - Country:US
Practice Address - Phone:509-582-3571
Practice Address - Fax:509-586-4383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602094837208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty