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WHITE RIVER FAMILY CARE LLC NPI 1649394800


NPI Information

NPI: 1649394800
Provider Name: WHITE RIVER FAMILY CARE LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 50D0635041

Address:
305 N.RIVER AVE.
BUCKLEY, WA
ZIP 98321
Phone: (360) 829-0625
Get Directions

WHITE RIVER FAMILY CARE LLC is a family medicine in Buckley, WA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. WHITE RIVER FAMILY CARE LLC NPI is 1649394800. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

305 N.RIVER AVE.
BUCKLEY, WA
ZIP 98321
Phone: (360) 829-0625
Fax: (360) 829-9860

The provider's authorized official is Cindy Jane Kruizenga .
The authorized official title is Office Manager and has the following contact phone number (360) 829-0625.

The CLIA number assigned to this NPI record is 50D0635041 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/16/2007 and was last updated on 10/4/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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