Individual
RICHARD WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
1900 116TH AVE NE, SUITE 210, BELLEVUE, WA 98004-3052
(425) 451-8831
(425) 451-8831
Mailing address
1900 116TH AVE NE, SUITE 210, BELLEVUE, WA 98004-3052
(425) 451-8831
(425) 451-8831
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
OI00000394
WA
224P00000X
Prosthetist
Primary
PS00000395
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9036963
—
WA
Enumeration date
08/09/2007
Last updated
09/25/2009
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