Provider Demographics
NPI:1134971674
Name:STARBIRD RISING WELLNESS
Entity type:Organization
Organization Name:STARBIRD RISING WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIX
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:253-686-1195
Mailing Address - Street 1:5323 98TH AVENUE CT W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98467-1109
Mailing Address - Country:US
Mailing Address - Phone:253-686-1195
Mailing Address - Fax:253-201-7025
Practice Address - Street 1:5323 98TH AVENUE CT W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98467-1109
Practice Address - Country:US
Practice Address - Phone:253-686-1195
Practice Address - Fax:253-201-7025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty