Provider Demographics
NPI:1811440407
Name:REINHARD, KARISA (LMP, DOULA)
Entity type:Individual
Prefix:MRS
First Name:KARISA
Middle Name:
Last Name:REINHARD
Suffix:
Gender:F
Credentials:LMP, DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6627 SKIPLEY RD
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-5148
Mailing Address - Country:US
Mailing Address - Phone:425-319-3171
Mailing Address - Fax:
Practice Address - Street 1:6627 SKIPLEY RD
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-5148
Practice Address - Country:US
Practice Address - Phone:425-319-3171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60491356225700000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No374J00000XNursing Service Related ProvidersDoula