NPIMap

Organization Active NPI

White River Family Health Clinic

  • Family Medicine Physician
  • Auburn, WA
National Provider Identifier
1871501742
Registry record updated Jul 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00041957 Issued in WA
Legal business name
WHITE RIVER FAMILY HEALTH CLINIC
Practice address
1340 M St SE
Suite a
Auburn, WA 98002-6755
Phone
(253) 735-2777
Fax
(253) 735-4153
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2024

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

Authorized official

Name
Joel Felipe, MDNPI 1366552838
Title
Owner
Phone
(253) 735-2777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD00041957 WA Primary

Addresses

Primary practice location

1340 M St SE
Suite a
Auburn, WA 98002-6755

Mailing address

1340 M St SE
Suite a
Auburn, WA 98002-6755
Phone (253) 735-2777

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D1046134White River Family Health Clinic1340 M Street SE Suite a, Auburn, WA 98002Provider-performed microscopyApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Emmal Felipe Enterprises 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.

Locations

1340 M St SE
Auburn, WA 98002

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722038400000",
    "number": "1871501742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 M ST SE",
            "address_2": "SUITE A",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980026755",
            "telephone_number": "253-735-2777",
            "fax_number": "253-735-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 M ST SE",
            "address_2": "SUITE A",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980026755",
            "telephone_number": "253-735-2777",
            "fax_number": "253-735-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE RIVER FAMILY HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2024-07-27",
        "certification_date": "2024-07-27",
        "status": "A",
        "authorized_official_last_name": "FELIPE",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-735-2777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00041957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.