Individual
PATRICK J REAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
34503 9TH AVE S, FEDERAL WAY, WA 98003-8727
(253) 835-8040
(253) 835-8035
Mailing address
34503 9TH AVE S, FEDERAL WAY, WA 98003-8727
(253) 835-8040
(253) 835-8035
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD00015641
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0239786
STATE L&I
WA
01
—
0296244
L&I
WA
05
—
1224906
—
WA
01
—
7543RD
INDIVIDUAL BLUE SHIELD
WA
01
—
MD5069W
ALASKA MEDICAID
WA
01
—
P07544
PIERCE COUNTY
WA
Enumeration date
02/06/2006
Last updated
08/23/2012
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