Provider Demographics
NPI:1952712093
Name:REINKE, TESSA MARIE (MD)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:MARIE
Last Name:REINKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TESSA
Other - Middle Name:M
Other - Last Name:WINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:423 N 3RD AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1511
Mailing Address - Country:US
Mailing Address - Phone:208-265-2221
Mailing Address - Fax:
Practice Address - Street 1:423 N 3RD AVE STE 210
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1511
Practice Address - Country:US
Practice Address - Phone:208-265-2221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60729630207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine