Provider Demographics
NPI:1033452156
Name:SOLITAIRE, RICHARD WILLIAM (MA, LMHC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:WILLIAM
Last Name:SOLITAIRE
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 S. HUSON DRIVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405
Mailing Address - Country:US
Mailing Address - Phone:253-441-9883
Mailing Address - Fax:877-346-2980
Practice Address - Street 1:4301 S. PINE ST.
Practice Address - Street 2:30-19
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409
Practice Address - Country:US
Practice Address - Phone:253-441-9883
Practice Address - Fax:877-346-2980
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60334940101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2064808Medicaid