Provider Demographics
NPI:1184779845
Name:REIFF, DAN W (PHD)
Entity type:Individual
Prefix:MR
First Name:DAN
Middle Name:W
Last Name:REIFF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9725 SE 36TH ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-3841
Mailing Address - Country:US
Mailing Address - Phone:206-232-8404
Mailing Address - Fax:
Practice Address - Street 1:9725 SE 36TH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-3841
Practice Address - Country:US
Practice Address - Phone:206-232-8404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009322101YM0800X
WANU00000947133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered133N00000XDietary & Nutritional Service ProvidersNutritionist