Brautigam, Richard G

Brautigam, Richard G is an sole proprietor health care provider with primary practice located at 12121 E Broadway Ave Ste 1 , Spokane Valley WA 99206-4972. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Brautigam, Richard G can be contacted via phone (509) 928-1212.

Contact Information

Primary practice address
12121 E Broadway Ave Ste 1 Spokane Valley WA 99206-4972
Phone: (509) 928-1212
Fax: (509) 924-5035
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OD00000930 Washington

Profile Details

NPI number 1467428458
LBN Legal business name Brautigam, Richard G
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 28th, 2006
Last updated Apr 29th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467428458 NPPES
Washington MEDICAID 2085405
Washington Other DG8772
Washington Other 410006929
Washington Other DG8772

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