Green, Richard S
Green, Richard S is an sole proprietor health care provider with primary practice located at 13210 Se 240Th St Suite C-2, Kent WA 98042-5182. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Green, Richard S can be contacted via phone (253) 631-1530.Contact Information
Primary practice address
13210 Se 240Th St Suite C-2
Kent WA 98042-5182
Phone: (253) 631-1530
Fax: (253) 631-5262
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1648TX | Washington |
Profile Details
| NPI number | 1184619132 |
|---|---|
| LBN Legal business name | Green, Richard S |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 15th, 2005 |
| Last updated | Feb 23rd, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184619132 | NPPES |
| Washington | MEDICAID | 2001857 |
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