Healthcare Provider Details
I. General information
NPI: 1538204649
Provider Name (Legal Business Name): RICHARD PAUL SKREI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/20/2007
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4911 S REGAL ST STE A
SPOKANE WA
99223-7793
US
IV. Provider business mailing address
PO BOX 5299 MS: 1313-5-PCO
TACOMA WA
98415-0299
US
V. Phone/Fax
- Phone: 509-598-7810
- Fax: 509-448-0565
- Phone: 253-459-8009
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | E-9021 |
| License Number State | AR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | MD00031618 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: