Healthcare Provider Details

I. General information

NPI: 1306639521
Provider Name (Legal Business Name): THE RIVERS WELLNESS AND ADVOCACY FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16125 JUAN WD WAY NE
BOTHELL WA
98011-6489
US

IV. Provider business mailing address

11410 NE 124TH ST UNIT 901
KIRKLAND WA
98034-4305
US

V. Phone/Fax

Practice location:
  • Phone: 206-883-6049
  • Fax:
Mailing address:
  • Phone: 206-883-6049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SALOME BOHNE
Title or Position: FOUNDER AND CLINICAL DIRECTOR
Credential: LICSW
Phone: 206-883-6049