Individual
MARK T REEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
904 7TH AVE, SEATTLE, WA 98104-1132
(206) 223-6487
Mailing address
1100 9TH AVE, MS:M4-PA, SEATTLE, WA 98101-2756
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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