White River Family Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WHITE RIVER FAMILY CARE LLC

Practice address

305 N.River Ave.
Buckley, WA 98321

Phone

(360) 829-0625

Fax

(360) 829-9860

NPI assigned

Mar 16, 2007

Organization subpart

No

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

Authorized official

Name

Cindy Jane Kruizenga

Title

Office Manager

Phone

(360) 829-0625

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael A Welsh, MD

  • Family Medicine Physician
  • Buckley, WA
  • NPI 1235122763
  Medicare reassignment Care Compare group NPD
• Jefferson L Boulet, PAC

  • Medical Physician Assistant
  • Buckley, WA
  • NPI 1740274745
  Medicare reassignment Care Compare group
• Catherine A Hartjoy, PAC

  • Physician Assistant
  • Tacoma, WA
  • NPI 1275520066
  Medicare reassignment Care Compare group
• Mary Muth, PA-C, L.AC

  • Acupuncturist
  • University Place, WA
  • NPI 1801807128
  NPD (past)
• James L Parker, MD

  • Family Medicine Physician
  • Federal Way, WA
  • NPI 1649263161
  NPD (past)
• Scott D Hunt, PAC

  • Medical Physician Assistant
  • Salt Lake City, UT
  • NPI 1396767745
  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538611200000",
    "number": "1649394800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1268",
            "city": "BUCKLEY",
            "state": "WA",
            "postal_code": "98321",
            "telephone_number": "360-829-0625",
            "fax_number": "360-829-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 N.RIVER AVE.",
            "city": "BUCKLEY",
            "state": "WA",
            "postal_code": "98321",
            "telephone_number": "360-829-0625",
            "fax_number": "360-829-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE RIVER FAMILY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2018-10-04",
        "status": "A",
        "authorized_official_last_name": "KRUIZENGA",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-829-0625"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casandra Faith Capon Tran, ARNP
• Charla Travis
• Washington State Department of Social and Health Services (Rainier School Pharmacy)
• Mesa Eva Kate Webb, M.S., CCC-SLP
• Michael A Welsh, MD
• White River School District
• Carolyn Williams, CCC-SLP
• Cansas Eleanor Wilson, LF 61245115
• Wings of Grace Home Care Services LLC
• Matthew Woolery

• Family Medicine Physician in Buckley, WA
• Providers in Buckley, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.