Healthcare Provider Details

I. General information

NPI: 1225949332
Provider Name (Legal Business Name): RISEWELL MEDICAL PLLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7614 CREEKSIDE LN SW
ROCHESTER WA
98579-8687
US

IV. Provider business mailing address

7614 CREEKSIDE LN SW
ROCHESTER WA
98579-8687
US

V. Phone/Fax

Practice location:
  • Phone: 360-269-5900
  • Fax: 360-282-0719
Mailing address:
  • Phone: 360-269-5900
  • Fax: 360-282-0719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE LINDSAY JOHNSON
Title or Position: OWNER/OPERATOR
Credential: ARNP
Phone: 360-269-5900