Individual
KARLA RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
714 W PINE ST, NEWPORT, WA 99156-9046
(509) 447-3139
Mailing address
714 W PINE ST, NEWPORT, WA 99156-9046
(509) 447-3139
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
BG60505872
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BG60505872
WA STATE LICENSE
WA
Enumeration date
12/20/2013
Last updated
11/03/2022
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