Healthcare Provider Details

I. General information

NPI: 1770090078
Provider Name (Legal Business Name): BIANCA RIOS CHAMPOUX PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2018
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28101 E QUINCY AVE
WATKINS CO
80137-9502
US

IV. Provider business mailing address

28101 E QUINCY AVE WITHDRAWAL MANAGEMENT BLDG
WATKINS CO
80137-9502
US

V. Phone/Fax

Practice location:
  • Phone: 720-696-7800
  • Fax: 303-339-5337
Mailing address:
  • Phone: 720-696-7800
  • Fax: 303-339-5337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0004757
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: