MEDICARE: RIVERSIDE REFLECTIONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1003773839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERSIDE REFLECTIONS

Provider Business Mailing Address
First Line	:	1049 LAGUNA DR
Second Line	:
City	:	MOSES LAKE
State	:	WA
Zip	:	98837-9532
Country	:	US
Telephone Number	:	509-289-8757
Fax Number	:

Provider Business Practice Location Address
First Line	:	1049 LAGUNA DR
Second Line	:
City	:	MOSES LAKE
State	:	WA
Zip	:	98837-9532
Country	:	US
Telephone Number	:	509-289-8757
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KYLE GREGG
Credential	:	LMHCA
Telephone Number	:	206-923-8374

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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Directions to “RIVERSIDE REFLECTIONS ” Practice Location

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