Reyna, Jesus Bravo

Reyna, Jesus Bravo is an individual health care provider with primary practice located at 14434 Ambaum Blvd Sw Ste 5 , Burien WA 98166-1438. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Reyna, Jesus Bravo can be contacted via phone (206) 812-6140.

Contact Information

Primary practice address
14434 Ambaum Blvd Sw Ste 5 Burien WA 98166-1438
Phone: (206) 812-6140
Fax: (206) 812-2466
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP61382433 Washington

Profile Details

NPI number 1528763596
LBN Legal business name Reyna, Jesus Bravo
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2023
Last updated Nov 20th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528763596 NPPES
Washington MEDICAID 2249111

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