Healthcare Provider Details

I. General information

NPI: 1518021161
Provider Name (Legal Business Name): COLLEEN RICHARDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 07/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVENUE
SEATTLE WA
98101
US

IV. Provider business mailing address

325 9TH AVENUE
SEATTLE WA
98101
US

V. Phone/Fax

Practice location:
  • Phone: 206-731-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: