Individual
MR. MICHAEL JAMES REEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 ALDER STREET, SOUTH BEND, WA 98586
(360) 875-5526
(360) 875-6167
Mailing address
800 ALDER STREET PO BOX 438, SOUTH BEND, WA 98586
(360) 875-5526
(360) 875-6167
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30004395
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9619065
—
WA
Enumeration date
07/10/2006
Last updated
07/08/2007
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