Healthcare Provider Details

I. General information

NPI: 1427965607
Provider Name (Legal Business Name): RIES CAMACHO QUINONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7755 OFFICE PLAZA DR N STE 105
WEST DES MOINES IA
50266-2339
US

IV. Provider business mailing address

221 S LEAGUE RD
COLFAX IA
50054-7869
US

V. Phone/Fax

Practice location:
  • Phone: 515-505-7283
  • Fax:
Mailing address:
  • Phone: 515-205-8966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: