Provider Demographics
NPI:1205890571
Name:REINBOLD, ALISON JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:JEAN
Last Name:REINBOLD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:JEAN
Other - Last Name:REINBOLD-CARTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1535
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98401-1535
Mailing Address - Country:US
Mailing Address - Phone:253-761-4200
Mailing Address - Fax:253-383-3553
Practice Address - Street 1:222 15TH AVE SE
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3754
Practice Address - Country:US
Practice Address - Phone:253-841-4353
Practice Address - Fax:253-581-5698
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD1840922085R0202X
WAMD000293612085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0363914OtherLNI-TRA MEDICA IMAGING-KING
WA1004847Medicaid
WA0363917OtherLNI-CAROL MILGARD BREAST CENTER
OR500739380Medicaid
WA0363916OtherLNI-UNION AVENUE OPEN MRI
WA0363909OtherLNI-TRA MEDICAL IMAGING-PIERCE
WA0241055OtherLNI-DIAGNOSTIC IMAGING NW