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General NPI Number Information
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NPI Number | 1790552636
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Entity Type | Organization
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Legal Business Name | SEATTLE NAD PLLC
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Dates
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Enumeration Date | 12/11/2023
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 15144 SE 46TH WAY
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City | BELLEVUE
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State | WA
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Zip | 98006-3229
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Country | US
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Telephone | 206-695-2707
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Fax | 801-701-8387
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Provider Business Mailing Address
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Address Line | PO BOX 1775
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City | MERCER ISLAND
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State | WA
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Zip | 98040-1775
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Country | US
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Telephone | 952-417-6773
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Fax | 801-701-8387
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD EDUARDO REPASS
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Credential | MD
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Telephone | 952-417-6773
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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 |
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License Number State |
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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 |
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License Number State |
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