Provider Demographics
NPI:1750635306
Name:RIEHLE, BERNICE JOAN (LMP)
Entity Type:Individual
Prefix:
First Name:BERNICE
Middle Name:JOAN
Last Name:RIEHLE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 S SULLIVAN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-6019
Mailing Address - Country:US
Mailing Address - Phone:509-928-9098
Mailing Address - Fax:509-928-9091
Practice Address - Street 1:325 S SULLIVAN RD
Practice Address - Street 2:SUITE B
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99037-6019
Practice Address - Country:US
Practice Address - Phone:509-928-9098
Practice Address - Fax:509-928-9091
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60111913225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist