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General NPI Number Information
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NPI Number | 1316085855
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Entity Type | Individual
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Provider Name | RICHARD EDUARDO REPASS M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/04/2007
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 402 S 4TH AVE FL 2
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City | YAKIMA
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State | WA
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Zip | 98902-3546
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Country | US
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Telephone | 509-572-4084
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Fax |
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Provider Business Mailing Address
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Address Line | 402 S 4TH AVE FL 2
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City | YAKIMA
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State | WA
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Zip | 98902-3546
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Country | US
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Telephone | 509-572-4084
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 60341333
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 50953
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 60341333
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License Number State | WA
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