Individual
DR. RICHARD G BRAUTIGAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
12121 E BROADWAY AVE STE 1, SPOKANE VALLEY, WA 99206-4972
(509) 928-1212
(509) 924-5035
Mailing address
12121 E BROADWAY AVE STE 1, SPOKANE VALLEY, WA 99206-4972
(509) 928-1212
(509) 924-5035
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00000930
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2085405
—
WA
01
—
410006929
RAILROAD MEDICARE
WA
01
—
DG8772
PTAN
WA
Enumeration date
02/28/2006
Last updated
04/29/2008
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