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Individual

RICHARD G EDISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1012 S 3RD ST, DAYTON, WA 99328
(509) 382-2531
(509) 382-3205
Mailing address
1012 S 3RD ST, DAYTON, WA 99328
(509) 382-2531
(509) 382-3205

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004152
WA
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1017094
WA
05
1710096458
WA
01
219156
L&I
WA
01
315750
L&I POST 7/21/13
WA
01
8944040
CV
WA
01
P01256590
RR MEDICARE
WA
Enumeration date
08/29/2006
Last updated
11/14/2025
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