Healthcare Provider Details

I. General information

NPI: 1104243088
Provider Name (Legal Business Name): MATTHEW RICHEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 DESALES AVE STE F1009
CHATTANOOGA TN
37404-1161
US

IV. Provider business mailing address

PO BOX 31001-4114
PASADENA CA
91110-4114
US

V. Phone/Fax

Practice location:
  • Phone: 423-697-2000
  • Fax: 423-697-2320
Mailing address:
  • Phone: 425-261-4950
  • Fax: 425-261-4951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD61507040
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number63818
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: