Provider Demographics
NPI:1598409831
Name:REYES, EMILY (BA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 65TH AVE W
Mailing Address - Street 2:
Mailing Address - City:FIRCREST
Mailing Address - State:WA
Mailing Address - Zip Code:98466-6200
Mailing Address - Country:US
Mailing Address - Phone:253-566-5559
Mailing Address - Fax:
Practice Address - Street 1:2002 65TH AVE W
Practice Address - Street 2:
Practice Address - City:FIRCREST
Practice Address - State:WA
Practice Address - Zip Code:98466-6200
Practice Address - Country:US
Practice Address - Phone:253-566-5559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program