Provider Demographics
NPI:1164876868
Name:DOMBROWSKI, RIKA (RN, MS, MA, IBCLC)
Entity Type:Individual
Prefix:
First Name:RIKA
Middle Name:
Last Name:DOMBROWSKI
Suffix:
Gender:F
Credentials:RN, MS, MA, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 SUMAC ST
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:WI
Mailing Address - Zip Code:53575-3806
Mailing Address - Country:US
Mailing Address - Phone:608-616-9176
Mailing Address - Fax:
Practice Address - Street 1:802 SUMAC ST
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:WI
Practice Address - Zip Code:53575-3806
Practice Address - Country:US
Practice Address - Phone:608-616-9176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI152780-30163W00000X, 163WL0100X, 163WP1700X
CA498763163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse
No163WP1700XNursing Service ProvidersRegistered NursePerinatal