Provider Demographics
NPI:1528120649
Name:WILLIAMS, RICHARD F (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:F
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 ENSIGN RD NE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5425
Mailing Address - Country:US
Mailing Address - Phone:360-491-1112
Mailing Address - Fax:360-493-8160
Practice Address - Street 1:3425 ENSIGN RD NE
Practice Address - Street 2:SUITE 220
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5425
Practice Address - Country:US
Practice Address - Phone:360-491-1112
Practice Address - Fax:360-493-8160
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00016512207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8217101Medicaid
WA8869742Other8869742
WA0149442OtherLABOR & INDUSTRIES
WA110221312OtherRAILROAD MEDICARE
WA3911WIOtherCOUNTY
WA8869742Other8869742
WAA08656Medicare UPIN