Provider Demographics
NPI:1770940322
Name:REED, CINDY LUELLA (ARNP, RN)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:LUELLA
Last Name:REED
Suffix:
Gender:F
Credentials:ARNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1581
Mailing Address - Street 2:
Mailing Address - City:MATTAWA
Mailing Address - State:WA
Mailing Address - Zip Code:99349-0960
Mailing Address - Country:US
Mailing Address - Phone:509-932-4499
Mailing Address - Fax:509-932-5363
Practice Address - Street 1:210 GOVERNMENT RD
Practice Address - Street 2:
Practice Address - City:MATTAWA
Practice Address - State:WA
Practice Address - Zip Code:99349-5116
Practice Address - Country:US
Practice Address - Phone:509-932-4499
Practice Address - Fax:509-932-5363
Is Sole Proprietor?:No
Enumeration Date:2016-01-26
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP60629650363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2057392Medicaid
WA358313Other(L&I)