Provider Demographics
NPI:1932699758
Name:SAUL, RIVER
Entity Type:Individual
Prefix:
First Name:RIVER
Middle Name:
Last Name:SAUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LIUYUAN
Other - Middle Name:
Other - Last Name:HE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2509 RUBEL WAY APT K
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-8417
Mailing Address - Country:US
Mailing Address - Phone:763-360-5843
Mailing Address - Fax:
Practice Address - Street 1:12333 NE 130TH LN STE TAN 110
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7467
Practice Address - Country:US
Practice Address - Phone:425-285-0060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAOP61344115207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program