Provider Demographics
NPI:1710203930
Name:RIOMONDO, MARK G (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:G
Last Name:RIOMONDO
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 1:8250 165TH AVE NE STE 100
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-6628
Mailing Address - Country:US
Mailing Address - Phone:425-883-2543
Mailing Address - Fax:
Practice Address - Street 1:8250 165TH AVE NE STE 100
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-6628
Practice Address - Country:US
Practice Address - Phone:425-883-2543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2023-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60136168111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor