Provider Demographics
NPI:1376592162
Name:BATES, JAMES RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RICHARD
Last Name:BATES
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 1:9621 RIDGETOP BLVD NW
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8502
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:450 S KITSAP BLVD
Practice Address - Street 2:BLDG. 1, SUITE 250
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3773
Practice Address - Country:US
Practice Address - Phone:360-782-3000
Practice Address - Fax:360-782-3040
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00019963207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8627903Medicaid
BA9870OtherREGENCE BLUESHIELD
5482011OtherAETNA
WA75421OtherLABOR & INDUSTRIES
110011344OtherRAILROAD MEDICARE
110011344OtherRAILROAD MEDICARE
110011344OtherRAILROAD MEDICARE
WAG000250401Medicare PIN
WAG000250701Medicare PIN
WAG000250623Medicare PIN
5482011OtherAETNA
WA75421OtherLABOR & INDUSTRIES
WA8627903Medicaid
WAGAB04723Medicare PIN