Provider Demographics
NPI:1225682438
Name:SANTOS RIVERA, AIXA JANICE (DC)
Entity Type:Individual
Prefix:DR
First Name:AIXA
Middle Name:JANICE
Last Name:SANTOS RIVERA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 E MADISON ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-7022
Mailing Address - Country:US
Mailing Address - Phone:206-327-9328
Mailing Address - Fax:
Practice Address - Street 1:1420 E MADISON ST STE 1
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-7022
Practice Address - Country:US
Practice Address - Phone:206-327-9328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60973577111N00000X
WACH60973577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor