Individual provider Active NPI

Susan Marie Reis, MD

  • Family Medicine Physician
  • Snohomish, WA
National Provider Identifier
1689674830
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
WA24446 Issued in WA
Practice address
1212 10TH St
Suite a
Snohomish, WA 98290-2070
Phone
(360) 568-3627
Fax
(360) 568-8522
NPI assigned
Jul 29, 2005
Reactivated
Mar 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X WA24446 WA Primary

Addresses

Primary practice location

1212 10TH St
Suite a
Snohomish, WA 98290-2070

Mailing address

1212 10TH St
Suite a
Snohomish, WA 98290-2070
Phone (360) 568-3627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
WA24446WAMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1689674830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 10TH ST",
            "address_2": "SUITE A",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982902070",
            "telephone_number": "360-568-3627",
            "fax_number": "360-568-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 10TH ST",
            "address_2": "SUITE A",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982902070",
            "telephone_number": "360-568-3627",
            "fax_number": "360-568-8522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIS",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-29",
        "last_updated": "2026-07-13",
        "deactivation_date": "2006-03-22",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "WA24446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snohomish, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.