Provider Demographics
NPI:1003975103
Name:RIBELLIA, SAUL ELDON (DC)
Entity Type:Individual
Prefix:DR
First Name:SAUL
Middle Name:ELDON
Last Name:RIBELLIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 E BROADWAY AVE
Mailing Address - Street 2:SUITE 18
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-5934
Mailing Address - Country:US
Mailing Address - Phone:509-766-7300
Mailing Address - Fax:509-766-7400
Practice Address - Street 1:821 E BROADWAY AVE
Practice Address - Street 2:SUITE 18
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-5934
Practice Address - Country:US
Practice Address - Phone:509-766-7300
Practice Address - Fax:509-766-7400
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034472111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAV07347Medicare UPIN
WA8857214Medicare PIN
WA8857213Medicare PIN