Rediclinic of Wa, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REDICLINIC OF WA, LLC

Practice address

11700 Mukilteo Speedway Ste 500
Mukilteo, WA 98275-5435

Phone

(713) 335-1754

NPI assigned

Oct 2, 2014

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": "1412208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1831592062",
    "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": "11700 MUKILTEO SPEEDWAY STE 500",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982755435",
            "telephone_number": "713-335-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDICLINIC OF WA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-02",
        "last_updated": "2014-10-02",
        "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": []
}

• Amrita Raj
• Marie Ramirez, MSW, LICSW
• Stacia Kay Rapp
• Poonam Rauniyar, MD
• Saleemeh Razaghzadeh
• Heidi S. Rendall, MD
• Nicolene Kniskern Rhynard
• Rite Aid
• Ritual Massage and Bodywork
• Aaron G. Robins, M. DIV.

• Clinic/Center in Mukilteo, WA
• Providers in Mukilteo, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.