Provider Demographics
NPI:1942492384
Name:RIOJAS, GLORIA RODRIGUEZ (CDPT)
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:RODRIGUEZ
Last Name:RIOJAS
Suffix:
Gender:F
Credentials:CDPT
Other - Prefix:MS
Other - First Name:GLORIA
Other - Middle Name:RODRIGUEZ
Other - Last Name:RIOJAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CDPT
Mailing Address - Street 1:602 E. NOB HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901
Mailing Address - Country:US
Mailing Address - Phone:509-453-7144
Mailing Address - Fax:509-248-6780
Practice Address - Street 1:602 E. NOB HILL BLVD
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901
Practice Address - Country:US
Practice Address - Phone:509-453-7144
Practice Address - Fax:509-248-6780
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00057199174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARC00057199OtherWA STATE DEPT. OF HEALTH