Provider Demographics
NPI:1609958271
Name:REINKE, CURTIS DALE (MD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:DALE
Last Name:REINKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 BLACK HILLS LN SW STE C
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-8661
Mailing Address - Country:US
Mailing Address - Phone:360-956-1725
Mailing Address - Fax:360-705-2557
Practice Address - Street 1:405 BLACK HILLS LN SW STE C
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8661
Practice Address - Country:US
Practice Address - Phone:360-956-1725
Practice Address - Fax:360-705-2557
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00036884207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1106814Medicaid
WA126766OtherLABOR AND INDUSTRIES
WA1106814Medicaid
WAAB36330Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
WAG89296Medicare UPIN