Healthcare Provider Details

I. General information

NPI: 1396896551
Provider Name (Legal Business Name): CHRISTINE HALL RICHTER OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19116 33RD W AVE
SEATTLE WA
98101
US

IV. Provider business mailing address

19116 33RD W AVE
SEATTLE WA
98101
US

V. Phone/Fax

Practice location:
  • Phone: 425-712-7900
  • Fax: 425-712-7905
Mailing address:
  • Phone: 425-712-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOD00003090
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: