Provider Demographics
NPI:1538204649
Name:SKREI, RICHARD PAUL (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:PAUL
Last Name:SKREI
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:PO BOX 5299
Mailing Address - Street 2:MS: 1313-5-PCO
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98415-0299
Mailing Address - Country:US
Mailing Address - Phone:253-459-8009
Mailing Address - Fax:
Practice Address - Street 1:4911 S REGAL ST STE A
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-7793
Practice Address - Country:US
Practice Address - Phone:509-598-7810
Practice Address - Fax:509-448-0565
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-9021207Q00000X
WAMD00031618207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8156960Medicaid
WA080188627Medicare PIN
WAGAB32818Medicare PIN
WAE52276Medicare UPIN
WAG8871898Medicare PIN