Provider Demographics
NPI:1790830214
Name:RIGGAN, STEPHEN JAMES (LMP)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:JAMES
Last Name:RIGGAN
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12512 E 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-0540
Mailing Address - Country:US
Mailing Address - Phone:509-768-5582
Mailing Address - Fax:
Practice Address - Street 1:9803 E SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-3645
Practice Address - Country:US
Practice Address - Phone:509-893-8986
Practice Address - Fax:509-924-0997
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00009169225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist