Healthcare Provider Details

I. General information

NPI: 1801282561
Provider Name (Legal Business Name): RICHARD ECK ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 12/11/2020
Certification Date: 12/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E WHEELER RD
MOSES LAKE WA
98837-1820
US

IV. Provider business mailing address

660 S COOLIDGE ST
MOSES LAKE WA
98837-1872
US

V. Phone/Fax

Practice location:
  • Phone: 509-765-5606
  • Fax: 509-764-3244
Mailing address:
  • Phone: 509-765-5606
  • Fax: 509-764-3244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60784891
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60784891
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: