Provider Demographics
NPI:1255910832
Name:REES, MICHAEL D (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:REES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 E WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-3021
Mailing Address - Country:US
Mailing Address - Phone:307-248-1012
Mailing Address - Fax:
Practice Address - Street 1:118 S WHITCOMB AVE
Practice Address - Street 2:
Practice Address - City:TONASKET
Practice Address - State:WA
Practice Address - Zip Code:98855-9287
Practice Address - Country:US
Practice Address - Phone:509-486-3191
Practice Address - Fax:509-223-1742
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP61594494207P00000X, 207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program