White River MC Healthcare LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

Legal business name

WHITE RIVER MC HEALTHCARE LLC

Doing business as

White River Memory Care

Practice address

2454 Cole St
Enumclaw, WA 98022-3648

Phone

(360) 825-4565

NPI assigned

Jun 12, 2024

Last updated

Jun 12, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Mitchell

Title

Secretary

Phone

(801) 447-9829

Specialties & licenses 1

Addresses

Other names 1

• White River Memory Care Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1306688957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N UNIVERSITY AVE",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2454 COLE ST",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980223648",
            "telephone_number": "360-825-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE RIVER MC HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "801-447-9829"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White River Memory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Christina Werner, DPT
• Michelle Marie Werner, RDH
• Allison Carrie Wettstein
• Vicroria Ann Whisler, MA, LMFT
• White River Community Healthcare LLC (White River Assisted Living)
• Carol M Wick, PT, OTR/L
• Carla J Wilbur
• Teri Wilcox, L.M.P., L.E.
• Tanya Marie Wilke, MD
• Ryan Willis, DPT

• Alzheimer Center (Dementia Center) in Enumclaw, WA
• Providers in Enumclaw, WA by specialty
• Alzheimer Center (Dementia Center) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.