Provider Demographics
NPI:1285713693
Name:REUTER, DAVID GENE (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GENE
Last Name:REUTER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11724 NE 195TH STREET
Mailing Address - Street 2:SUITE #100
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011
Mailing Address - Country:US
Mailing Address - Phone:425-861-7599
Mailing Address - Fax:
Practice Address - Street 1:11724 NE 195TH STREET
Practice Address - Street 2:SUITE #100
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011
Practice Address - Country:US
Practice Address - Phone:425-318-3100
Practice Address - Fax:425-318-3101
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00035564208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8219875Medicaid
WAAB12316Medicare ID - Type Unspecified
WA8219875Medicaid