Provider Demographics
NPI:1083885651
Name:RICHARDSON BAY PHYSICIANS
Entity Type:Organization
Organization Name:RICHARDSON BAY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL OPERATIONS ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-838-6885
Mailing Address - Street 1:1601 5TH AVE
Mailing Address - Street 2:SUITE 830
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3621
Mailing Address - Country:US
Mailing Address - Phone:206-624-6050
Mailing Address - Fax:206-623-7674
Practice Address - Street 1:650 CASTRO ST
Practice Address - Street 2:120-426
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94041-2055
Practice Address - Country:US
Practice Address - Phone:800-417-1157
Practice Address - Fax:206-623-7674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA065470207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty