Provider Demographics
NPI:1346228806
Name:SATRE, RICHARD WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WILLIAM
Last Name:SATRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1535
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98401-1535
Mailing Address - Country:US
Mailing Address - Phone:253-761-4200
Mailing Address - Fax:253-383-3553
Practice Address - Street 1:1304 FAWCETT AVE STE 100
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-1900
Practice Address - Country:US
Practice Address - Phone:253-761-4200
Practice Address - Fax:253-761-4201
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD1665052085R0202X, 2085R0204X
WAMD000429422085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0322171OtherL&I-TRA REST OF WA
WA1008151Medicaid
WA0322167OtherL&I-UNION AVE OPEN MRI
OR028446Medicaid
WA0321389OtherL&I-TRA KING COUNTY
WAG8925788OtherPTAN-MIO1
WAG8925789OtherPTAN-TRA PIERCE CO
WA175532OtherL&I PROVIDER NUMBER
WAG8925787OtherMEDICARE PIN-UNION AVENUE OPEN MRI
WA0322171OtherL&I PROVIDER NUMBER-TRA
ORR169046OtherPTAN-PENDLETON, OREGON
WA175283OtherL&I PROVIDER NUMBER
WA0321389OtherL&I-TRA
WAG8925789OtherPTAN-TRA PIERCE CO
WA203276OtherL&I PROVIDER NUMBER
WA8862875Medicare PIN
ORR169046OtherPTAN-PENDLETON, OREGON
WAG8925788OtherPTAN-MIO1