Healthcare Provider Details

I. General information

NPI: 1487584058
Provider Name (Legal Business Name): HENRY JAY RICHARDS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6523 CALIFORNIA AVE SW STE 136
SEATTLE WA
98136-1833
US

IV. Provider business mailing address

4701 SW JUNEAU ST
SEATTLE WA
98136-1315
US

V. Phone/Fax

Practice location:
  • Phone: 206-423-9848
  • Fax: 641-347-3725
Mailing address:
  • Phone: 206-423-9848
  • Fax: 641-347-3725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSYC.PY.00002571
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: