# RICHARD G EDISON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1710096458
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA10004152 | WA | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |

## Other

- **Enumeration date:** 08/29/2006
- **Last updated:** 11/14/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1017094 | — | WA |
| 05 | — | 1710096458 | — | WA |
| 01 | — | 219156 | L&I | WA |
| 01 | — | 315750 | L&I POST 7/21/13 | WA |
| 01 | — | 8944040 | CV | WA |
| 01 | — | P01256590 | RR MEDICARE | WA |