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NPI Code Detail

MEDICARE: RILEY SAWYER

MEDICARE: RILEY SAWYER
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
1363A00000XPhysician AssistantPA.0009477CO

General Provider Information

NPI Number : 1982568218
Entity Type Code : Individual
Provider Name (Legal Business Name) : RILEY SAWYER
Provider Business Mailing Address
First Line : 2525 13TH ST
Second Line :
City : BOULDER
State : CO
Zip : 80304-4104
Country : US
Telephone Number : 303-650-4460
Fax Number :
Provider Business Practice Location Address
First Line : 2525 13TH ST
Second Line :
City : BOULDER
State : CO
Zip : 80304-4104
Country : US
Telephone Number : 303-650-4460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2025
Last Update Date : 12/11/2025

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Directions to “ RILEY SAWYER ” Practice Location

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