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General NPI Number Information
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NPI Number | 1871501742
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Entity Type | Organization
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Legal Business Name | WHITE RIVER FAMILY HEALTH CLINIC
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 07/27/2024
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Provider Practice Location Address
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Address Line | 1340 M ST SE SUITE A
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City | AUBURN
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State | WA
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Zip | 98002-6755
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Country | US
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Telephone | 253-735-2777
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Fax | 253-735-4153
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Provider Business Mailing Address
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Address Line | 1340 M ST SE SUITE A
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City | AUBURN
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State | WA
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Zip | 98002-6755
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Country | US
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Telephone | 253-735-2777
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Fax | 253-735-4153
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Authorized Official
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Title or Position | OWNER
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Name | JOEL FELIPE
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Credential | MD
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Telephone | 253-735-2777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00041957
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License Number State | WA
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