Individual
RICHARD C. WAHLGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M-PT
Contact information
Practice address
122 3RD ST NE, AUBURN, WA 98002-4013
(253) 833-7750
(253) 887-9804
Mailing address
122 3RD ST NE, AUBURN, WA 98002-4013
(253) 833-7750
(253) 887-9804
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT00007229
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135296
LABOR & INDUSTRIES
WA
01
—
5338WA
REGENCE
WA
01
—
GAB15557
MEDICARE LEGACY
WA
Enumeration date
01/09/2006
Last updated
04/19/2010
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