Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | CH00003033 | WA |
NPI | 1558572982 |
---|---|
Provider Name | Dr. Richard W Rivera |
First Address | Seahurst, WA 98062-0960 |
Second Address | Burien, WA 98166-2216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 05/11/2012 |