Provider Demographics
NPI:1902437403
Name:REJENS MEDICAL GROUP, PLLC
Entity Type:Organization
Organization Name:REJENS MEDICAL GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESHWAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-889-6183
Mailing Address - Street 1:14241 NE WOODINVILLE DUVALL RD # 354
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-8564
Mailing Address - Country:US
Mailing Address - Phone:760-889-6183
Mailing Address - Fax:
Practice Address - Street 1:19312 KINGS GARDEN DR N
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133
Practice Address - Country:US
Practice Address - Phone:206-546-7340
Practice Address - Fax:206-289-7816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty