Individual
JOHNNY RAY RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1210 SW 136TH ST, BURIEN, WA 98166-1214
(206) 257-6600
Mailing address
3691 SESTO CT, LAS VEGAS, NV 89141-3404
(580) 649-8053
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN61276339
WA
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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