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Individual

JACOB JOSEPH REINEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2811 TIETON DR, YAKIMA, WA 98902-3761
(509) 575-8000
Mailing address
406 S 30TH AVE, SUITE 202, YAKIMA, WA 98902-3713
(509) 972-1051

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
754407
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
194807701
TX
01
89029U
BCBS
TX
01
P00711635
RAILROAD
TX
Enumeration date
07/20/2007
Last updated
07/17/2009
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