Provider Demographics
NPI:1710665328
Name:STRATTON, REID JACOB
Entity Type:Individual
Prefix:
First Name:REID
Middle Name:JACOB
Last Name:STRATTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 REKA DR APT F2
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-3535
Mailing Address - Country:US
Mailing Address - Phone:907-250-8672
Mailing Address - Fax:
Practice Address - Street 1:4010 REKA DR APT F2
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3535
Practice Address - Country:US
Practice Address - Phone:907-250-8672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist