Healthcare Provider Details

I. General information

NPI: 1538234737
Provider Name (Legal Business Name): RICHARD D. LAWSON PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 112TH AVE NE SUITE 300
BELLEVUE WA
98004-2943
US

IV. Provider business mailing address

2025 112TH AVE. N.E. SUITE 300
BELLEVUE WA
98004
US

V. Phone/Fax

Practice location:
  • Phone: 206-654-5193
  • Fax: 425-452-5683
Mailing address:
  • Phone: 206-654-5193
  • Fax: 425-452-5683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1332
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: