Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | AP60686042 | WA |
NPI | 1003293069 |
---|---|
Provider Name | Liane Mf Richter |
First Address | Seattle, WA 98124-1876 |
Second Address | Seattle, WA 98102-5711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2015 |
Last Update Date | 18/12/2019 |