Healthcare Provider Details

I. General information

NPI: 1003293069
Provider Name (Legal Business Name): LIANE MF RICHTER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIANE FERNYHOUGH ARNP

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 BROADWAY E
SEATTLE WA
98102-5711
US

IV. Provider business mailing address

PO BOX 34876
SEATTLE WA
98124-1876
US

V. Phone/Fax

Practice location:
  • Phone: 206-465-0316
  • Fax:
Mailing address:
  • Phone: 425-656-5412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60686042
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2299273
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: