Rediclinic of Wa, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REDICLINIC OF WA, LLC

Practice address

21302 State Route 410 E
Bonney Lake, WA 98391-8468

Phone

(713) 335-1742

Fax

(713) 358-4881

NPI assigned

May 4, 2015

Organization subpart

No

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

Authorized official

Name

Danielle Barrera

Title

Chief Operating Officer

Phone

(713) 580-9489

Specialties & licenses 1

Addresses

Tax ID family

Rediclinic of Wa LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Rediclinic of Wa, LLC

  • Clinic/Center
  • Bothell, WA
  • NPI 1588041107
  NPD tax ID

Locations

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1073990610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 GREENWAY PLZ",
            "address_2": "STE. 2950",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460905",
            "telephone_number": "713-335-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21302 STATE ROUTE 410 E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983918468",
            "telephone_number": "713-335-1742",
            "fax_number": "713-358-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDICLINIC OF WA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "BARRERA",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "713-580-9489"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rainier Biobehavioral Institute, LLC (Rbi)
• Rainier Biobehavioral Institute, LLC (Rbi)
• Archana Madhuri Rajan, M.D
• Shona Catherine Ramsay, MS, ATC, LAT
• Courtney Dyan Randolph, ARNP
• Rehan Bashar DDS PLLC (Crescent Dental Bonney Lake)
• Van Reid, D.D.S
• Tammy Lee Remick, LMP
• Renal Care Group Northwest, Inc. (Fresenius Kidney Care Bonney Lake)
• Diego Alexander Reyes, SPANISH INTERPRETER

• Clinic/Center in Bonney Lake, WA
• Providers in Bonney Lake, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; 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.