Healthcare Provider Details

I. General information

NPI: 1811015688
Provider Name (Legal Business Name): RICHARD DUANE HEHN OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 SLEATER KINNEY SE SUITE 1300
OLYMPIA WA
98503
US

IV. Provider business mailing address

7827 MOUNTAIN AIRE LP SE
OLYMPIA WA
98503
US

V. Phone/Fax

Practice location:
  • Phone: 360-493-1790
  • Fax: 360-491-8702
Mailing address:
  • Phone: 360-493-1790
  • Fax: 360-491-8702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number803TX
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1001
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: