Provider Demographics
NPI:1588840326
Name:REEVES, JANETTE MARIE (DO)
Entity Type:Individual
Prefix:
First Name:JANETTE
Middle Name:MARIE
Last Name:REEVES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3475 N SARATOGA ST
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98278-4927
Mailing Address - Country:US
Mailing Address - Phone:360-257-9561
Mailing Address - Fax:360-257-9878
Practice Address - Street 1:3475 N SARATOGA ST
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98278-4102
Practice Address - Country:US
Practice Address - Phone:360-257-9561
Practice Address - Fax:360-257-9878
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005129207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ439897Medicaid
AZZ140387Medicare PIN