Provider Demographics
NPI:1366504573
Name:WRIGHT, RICHARD K (PT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:K
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 W LEWIS ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-5561
Mailing Address - Country:US
Mailing Address - Phone:509-544-0265
Mailing Address - Fax:509-544-0304
Practice Address - Street 1:824 W LEWIS ST
Practice Address - Street 2:SUITE 204
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-5561
Practice Address - Country:US
Practice Address - Phone:509-544-0265
Practice Address - Fax:509-544-0304
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00002559225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB12108Medicare ID - Type Unspecified