Provider Demographics
NPI:1558572982
Name:RIVERA, RICHARD W (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:W
Last Name:RIVERA
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:PO BOX 960
Mailing Address - Street 2:
Mailing Address - City:SEAHURST
Mailing Address - State:WA
Mailing Address - Zip Code:98062-0960
Mailing Address - Country:US
Mailing Address - Phone:206-433-2070
Mailing Address - Fax:206-244-5838
Practice Address - Street 1:629 SW 153RD ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2216
Practice Address - Country:US
Practice Address - Phone:206-433-2070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003033111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic