Provider Demographics
NPI:1083759005
Name:ORSKOG, RICHARD V
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:V
Last Name:ORSKOG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 S BURLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-3223
Mailing Address - Country:US
Mailing Address - Phone:360-757-5701
Mailing Address - Fax:
Practice Address - Street 1:1725 S BURLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-3223
Practice Address - Country:US
Practice Address - Phone:360-757-5701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3492152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist