Provider Demographics
NPI:1669708640
Name:REIMER, MELISSA A (IDMT)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:A
Last Name:REIMER
Suffix:
Gender:F
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:591 BARNES BLVD
Mailing Address - Street 2:
Mailing Address - City:JOINT-BASE LEWIS MCCHORD
Mailing Address - State:WA
Mailing Address - Zip Code:98438
Mailing Address - Country:US
Mailing Address - Phone:253-982-5566
Mailing Address - Fax:
Practice Address - Street 1:691 BARNES BLVD
Practice Address - Street 2:
Practice Address - City:MCCHORD AFB
Practice Address - State:WA
Practice Address - Zip Code:98438-1303
Practice Address - Country:US
Practice Address - Phone:253-982-3518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians