Green, Richard S

Green, Richard S is an sole proprietor health care provider with primary practice located at 13210 Se 240Th St Suite C-2, Kent WA 98042-5182. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Green, Richard S can be contacted via phone (253) 631-1530.

Contact Information

Primary practice address
13210 Se 240Th St Suite C-2 Kent WA 98042-5182
Fax: (253) 631-5262
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1648TX Washington

Profile Details

NPI number 1184619132
LBN Legal business name Green, Richard S
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 15th, 2005
Last updated Feb 23rd, 2010 - about 14 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 1184619132 NPPES
Washington MEDICAID 2001857

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