Provider Demographics
NPI:1770799579
Name:RIOJAS, FAUSTINO JR (MD)
Entity type:Individual
Prefix:
First Name:FAUSTINO
Middle Name:
Last Name:RIOJAS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 W MARGARET ST
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-4126
Mailing Address - Country:US
Mailing Address - Phone:509-542-9940
Mailing Address - Fax:888-326-9711
Practice Address - Street 1:707 W MARGARET
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301
Practice Address - Country:US
Practice Address - Phone:509-542-9940
Practice Address - Fax:509-542-9942
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00031023207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1111772Medicaid
WAGAB18032Medicare ID - Type Unspecified
WA1111772Medicaid