Healthcare Provider Details

I. General information

NPI: 1578528519
Provider Name (Legal Business Name): RICHARD PARKER BILLINGHAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 11/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MADISON ST STE 500
SEATTLE WA
98104-3557
US

IV. Provider business mailing address

1101 MADISON ST STE 500
SEATTLE WA
98104-3557
US

V. Phone/Fax

Practice location:
  • Phone: 206-386-6600
  • Fax: 206-386-2452
Mailing address:
  • Phone: 206-386-6600
  • Fax: 206-386-2452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberMD00013877
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: