Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD61178273 | WA |
Y | 207YP0228X | Pediatric Otolaryngology | MD61178273 | WA |
NPI | 1952796195 |
---|---|
Provider Name | Clare M Richardson |
First Address | Seattle, WA 98145-5005 |
Second Address | Seattle, WA 98105-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2015 |
Last Update Date | 21/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1952796195 | (05) | WA |