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Individual

DR. THOMAS M RICHARDSON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12728 19TH AVE SE, SUITE 200, EVERETT, WA 98208-6526
(425) 225-2700
(425) 225-2790
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 747-2455

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD00044733
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
199330
L&I
WA
05
8425258
WA
01
MD00044733
STATE LICENSE NUMBER
WA
01
P00226719
RR MEDICARE
Enumeration date
06/08/2006
Last updated
07/12/2016
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