Provider Demographics
NPI:1619972320
Name:REUTER, JASON M (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:M
Last Name:REUTER
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 1:105 W 8TH AVE
Mailing Address - Street 2:SUITE 6060
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2302
Mailing Address - Country:US
Mailing Address - Phone:509-838-4211
Mailing Address - Fax:509-838-6432
Practice Address - Street 1:105 W 8TH AVE
Practice Address - Street 2:SUITE 6060
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2302
Practice Address - Country:US
Practice Address - Phone:509-838-4211
Practice Address - Fax:509-838-6432
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00044875207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00296019OtherRR MEDICARE
WA8429490Medicaid
WA8906482OtherCRIME VICTIMS
OR213536Medicaid
WA0198857OtherLABOR & IND.
WA8429490Medicaid
WA8854486Medicare PIN