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Individual
MARK T REEVES
Active
Individual
MARK T REEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000453
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039594
LABOR & INDUSTRY
WA
05
—
8133258
—
WA
01
—
RE6691
BLUE SHIELD
WA
01
—
US0861761
AETNA/USHC SPECIALIST
WA
Enumeration date
08/15/2006
Last updated
06/17/2008
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