Provider Demographics
NPI:1174681472
Name:HAUSER, RICHARD ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALAN
Last Name:HAUSER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 E SELTICE WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854
Mailing Address - Country:US
Mailing Address - Phone:208-777-1638
Mailing Address - Fax:208-777-9100
Practice Address - Street 1:614 E SELTICE WAY
Practice Address - Street 2:SUITE A
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-6367
Practice Address - Country:US
Practice Address - Phone:208-777-1638
Practice Address - Fax:208-777-9100
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA846111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDC8471OtherBLUE CROSS
ID000010023270OtherREGENCE BLUE SHIELD
1675603Medicare ID - Type Unspecified
1378906Medicare ID - Type Unspecified