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Individual

SHAUNA M RICHERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
304 W BAY DR NW, SUITE 301, OLYMPIA, WA 98502-4958
(360) 413-8760
(360) 413-8839
Mailing address
304 W BAY DR NW, SUITE 301, OLYMPIA, WA 98502-4958
(360) 413-8760
(360) 413-8839

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD00035844
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8221830
WA
01
GAB20354
MEDICARE
WA
Enumeration date
07/28/2005
Last updated
10/22/2013
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