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Individual

ELIZABETH JEAN REYNOLDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
840 E HILL AVE, MOSES LAKE, WA 98837-2238
(509) 764-6400
Mailing address
840 E HILL AVE, MOSES LAKE, WA 98837-2238
(509) 764-6400

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P01336668
RR MEDICARE
WA
Enumeration date
09/15/2010
Last updated
10/17/2022
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