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Individual

RICHARD K. GREEN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
13712 NE 10TH AVE, VANCOUVER, WA 98685-2628
(360) 823-0860
(360) 828-1407
Mailing address
PO BOX 821350, VANCOUVER, WA 98682-0030
(360) 687-5221
(360) 666-0466

Taxonomy

Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
MD00033630
WA
2086S0122X
Plastic and Reconstructive Surgery Physician
MD00033630
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8190035
WA
Enumeration date
07/13/2005
Last updated
07/19/2011
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