Provider Demographics
NPI:1255380804
Name:REYES, HECTOR DECENA JR (MD)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:DECENA
Last Name:REYES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:450 S KITSAP BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-3773
Mailing Address - Country:US
Mailing Address - Phone:360-874-5900
Mailing Address - Fax:253-530-2970
Practice Address - Street 1:450 S KITSAP BLVD
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3773
Practice Address - Country:US
Practice Address - Phone:360-874-5900
Practice Address - Fax:253-530-2970
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00048479207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1060220Medicaid