Provider Demographics
NPI:1831185347
Name:REED, MARK A (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:REED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 SE CAMANO DR
Mailing Address - Street 2:
Mailing Address - City:CAMANO ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98282-8489
Mailing Address - Country:US
Mailing Address - Phone:206-419-7297
Mailing Address - Fax:
Practice Address - Street 1:963 SE CAMANO DR
Practice Address - Street 2:
Practice Address - City:CAMANO ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98282-8489
Practice Address - Country:US
Practice Address - Phone:206-419-7297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE3497207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR148389001Medicaid
AR5M339OtherAR BCBS
E17800Medicare UPIN
AR5M339OtherAR BCBS