Doctor Name: | PAULA J RIDER |
NPI Number: | 1356599609 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMP |
License Number: | MA00023762 |
Business Practice Address: | 3920 W Tapps Dr E Lake Tapps, WA - 983919176 |
Business Phone Number: | 2533105333 |
Business Fax Number: | 2538264792 |
Mailing Address: | Po Box 610, SUMNER |
State: | WA |
Postal Code: | 983900110 |
Phone Number: | 2533105333 |
Fax Number: | 2538264792 |
NPI Enumeration Date: | 08/28/2008 |
NPI Last Update Date: | 08/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA00023762 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |