Healthcare Provider Details

I. General information

NPI: 1245010271
Provider Name (Legal Business Name): EMILY RICHARDS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMILY KEISTER

II. Dates (important events)

Enumeration Date: 10/05/2023
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 W WASHINGTON ST
SEQUIM WA
98382-3266
US

IV. Provider business mailing address

955 W WASHINGTON ST
SEQUIM WA
98382-3266
US

V. Phone/Fax

Practice location:
  • Phone: 360-406-2036
  • Fax:
Mailing address:
  • Phone: 360-406-2036
  • Fax: 360-406-2037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberAT4773
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOD61567153
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: