Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 37335 | IA |
N | 208600000X | Surgeon | 37335 | IA |
Y | 208200000X | Surgeon | MD60027943 | WA |
Y | 208600000X | Surgeon | MD60027943 | WA |
N | 208200000X | Surgeon | R6805 | IA |
N | 208600000X | Surgeon | R6805 | IA |
N | 2086X0206X | Surgical Oncologist | 37335 | IA |
N | 2086X0206X | Surgical Oncologist | MD60027943 | WA |
NPI | 1285843235 |
---|---|
Provider Name | Heidi H Richardson |
First Address | Spokane, WA 99220-3649 |
Second Address | Spokane, WA 99204-2966 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 04/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
70042 | WELLMARK BCBS (01) | IA |