Provider Demographics
NPI:1932881455
Name:STEMBAUGH-REYES, KEVIN (CNA)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:STEMBAUGH-REYES
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 N ARGONNE RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2657
Mailing Address - Country:US
Mailing Address - Phone:509-505-5315
Mailing Address - Fax:
Practice Address - Street 1:1227 N ARGONNE RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2657
Practice Address - Country:US
Practice Address - Phone:509-505-5315
Practice Address - Fax:509-530-2837
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANC61179577376K00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide