Individual
JEAN PIERE RIVERA NIEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
10004 204TH AVE E, BONNEY LAKE, WA 98391-6539
(253) 848-5951
Mailing address
2904 4TH AVE NE, PUYALLUP, WA 98372-7053
(253) 286-4142
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA61031699
WA
Other
Enumeration date
03/05/2020
Last updated
02/13/2025
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