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REDICLINIC OF WA, LLC
NPI 1073990610
Clinic/Center in Bonney Lake, WA

Active since May 04, 2015
21302 STATE ROUTE 410 E, BONNEY LAKE, WA 98391(713) 335-1742(713) 358-4881 Get Directions Write a Review

NPPES record last updated: May 4, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Rediclinic Of Wa, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REDICLINIC OF WA, LLC (NPI 1073990610) is a healthcare organization registered as a clinic/center in Bonney Lake, Washington and active in the NPI registry since May 2015. The organization lists Danielle Barrera, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1073990610
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameREDICLINIC OF WA, LLC
Location Address21302 STATE ROUTE 410 EBonney Lake, WA 98391-8468
Mailing Address9 Greenway Plz, Ste. 2950Houston, TX 77046-0905 · (713) 335-1754
Phone(713) 335-1742
Fax(713) 358-4881
Organization SubpartNo
Authorized OfficialDanielle BarreraChief Operating Officer · (713) 580-9489
Enumeration DateMay 4, 2015
✔ NPI 1073990610 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
21302 STATE ROUTE 410 E, Bonney Lake, WA 98391
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Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PETER RANDOLF JONES RPH
Pharmacist
21302 STATE ROUTE 410 E
BONNEY LAKE, WA 98391
Pierce County (253) 862-2822
IVY DANG PHARMD
Pharmacist
21302 STATE ROUTE 410 E
BONNEY LAKE, WA 98391
Pierce County (253) 862-2822
KELSEY WILLIAMS RN, BSN
Registered Nurse
21302 STATE ROUTE 410 E
BONNEY LAKE, WA 98391
Pierce County (513) 324-5209
MICHAEL RODRIGUEZ
Pharmacy Technician
21302 STATE ROUTE 410 E
BONNEY LAKE, WA 98391
Pierce County (253) 862-2822
MRS. NISHY KAUR HAYRE
Pharmacist
21302 STATE ROUTE 410 E
BONNEY LAKE, WA 98391
Pierce County (253) 862-2822
AMIT TIWARI MS RPH
Pharmacist
21302 STATE ROUTE 410 E
BONNEY LAKE, WA 98391
Pierce County (253) 862-2822
KAITLYN KOSAI PHARMD
Pharmacist
21302 STATE ROUTE 410 E
BONNEY LAKE, WA 98391
Pierce County (253) 861-2822
MRS. STEPHANIE G HOOK PHARMD
Pharmacist
21302 STATE ROUTE 410 E
BONNEY LAKE, WA 98391
Pierce County (253) 862-2822

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rediclinic Of Wa, LLC's NPI number?

The NPI number for Rediclinic Of Wa, LLC is 1073990610. It was assigned to this organization in the NPPES registry on May 4, 2015.

Where is Rediclinic Of Wa, LLC located?

Rediclinic Of Wa, LLC is located at 21302 State Route 410 E, Bonney Lake, WA 98391. The listed phone number is (713) 335-1742.

What is Rediclinic Of Wa, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Rediclinic Of Wa, LLC was last updated on May 4, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.