Rediclinic of Wa, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REDICLINIC OF WA, LLC

Practice address

2131 SW 336TH St
Federal Way, WA 98023-2847

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

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": "1164809703",
    "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",
            "fax_number": "713-358-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 SW 336TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232847",
            "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": []
}

• Sean Robert Reardon, COUNSELOR
• Joann Elizabeth Recor, RN
• Recovery Innovations Inc
• Anita Reddy, MD
• Sivaprasad M Reddy, MD
• Katherine R Redmon, PAC
• Meagan Reece, PSYD
• Brandy Reed
• Laura Reed, DC
• Caitlin B Reese, DPT

• Clinic/Center in Federal Way, WA
• Providers in Federal Way, 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.