Rediclinic of Wa, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REDICLINIC OF WA, LLC

Practice address

22631 Bothell Everett Hwy
Bothell, WA 98021-8401

Phone

(713) 335-1742

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
  • Bonney Lake, WA
  • NPI 1073990610
  NPD tax ID

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": "1588041107",
    "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": "22631 BOTHELL EVERETT HWY",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980218401",
            "telephone_number": "713-335-1742"
        }
    ],
    "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": []
}

• Roxanna Rangel, RDA
• Molly Robyn Rauschl, BCBA, LBA
• Swardhu Raut
• Ashley Raymond, FNP
• Alexya Rayo
• Natalia Helena Reeck
• Katelyn Reed
• Megan Reed
• Refresh Day Spa
• Regents Dietitian Services

• Clinic/Center in Bothell, WA
• Providers in Bothell, 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.