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NPI Code Detail

MEDICARE: DR. RICHARD JOSEPH STRIDE

MEDICARE: DR. RICHARD JOSEPH STRIDE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLH00003685WA

General Provider Information

NPI Number : 1114099223
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD JOSEPH STRIDE
Provider Business Mailing Address
First Line : 2428 W REYNOLDS AVE
Second Line :
City : CENTRALIA
State : WA
Zip : 98531-4554
Country : US
Telephone Number : 603-309-0443
Fax Number : 360-736-3139
Provider Business Practice Location Address
First Line : 2428 W REYNOLDS AVE
Second Line :
City : CENTRALIA
State : WA
Zip : 98531-4554
Country : US
Telephone Number : 360-330-9044
Fax Number : 360-736-3139
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 05/20/2024

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Directions to “ DR. RICHARD JOSEPH STRIDE ” Practice Location

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