Provider Demographics
NPI:1730126277
Name:AYOUB, REINHILD ELISABETH (MD)
Entity Type:Individual
Prefix:
First Name:REINHILD
Middle Name:ELISABETH
Last Name:AYOUB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REINHILD
Other - Middle Name:ELISABETH
Other - Last Name:NAUMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:139 1ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:WA
Mailing Address - Zip Code:98611
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:139 1ST AVE SW
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:WA
Practice Address - Zip Code:98611
Practice Address - Country:US
Practice Address - Phone:360-274-6349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00026734208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8230864Medicaid
WA0253830OtherLABOR & INDUSTRIES
F91236Medicare UPIN
WA8230864Medicaid
WAAB04841Medicare PIN
WA0253830OtherLABOR & INDUSTRIES