Individual
RICHARD S GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
13210 SE 240TH ST, SUITE C-2, KENT, WA 98042-5182
(253) 631-1530
(253) 631-5262
Mailing address
13210 SE 240TH ST, SUITE C-2, KENT, WA 98042-5182
(253) 631-1530
(253) 631-5262
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1648TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2001857
—
WA
Enumeration date
09/15/2005
Last updated
02/23/2010
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